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Accessibility Services - CollegeBound Registration Form (Timmins)

First Name:_______________________________

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Referenced from: CollegeBound: A Post-Secondary Transitional Program

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Accessibility Services - CollegeBound Registration Form (Timmins)

First Name:_______________________________

Last Name:_______________________________

Preferred Name:__________________________

Cell Phone:_______________________________

Address: _________________________________

Email:____________________________________

City:_____________________

Province:__________________

Postal Code:__________________

Current School (if applicable):

______________________________________________________________

Program/Area of Study at Northern College (if applicable):_____________________________________

Please submit any accessibility support documentation (e.g PsychEd Assessment, IEP , or medical documentation) with this application, if you are submitting via email.

Documentation is attached.

Documentation to follow.

Housing Information (Please check one.)

I have housing procured.

I will be living in Residence.

I have not secured housing and need temporary accommodation during CollegeBound.

Personal Information Do you have allergies and/or food sensitivities?

Yes

If yes, please list: ____________________________________________

Relationship: _____________________________

Emergency Contact Information

Emergency Contact:_________________________

Telephone:_________________________________

Alt. Telephone:____________________________

  •  I understand that there is a 100% attendance policy for CollegeBound.

  •  I understand that this is a substance-free environment.

  •  I understand that CollegeBound requires a personal laptop . Tablets and Chromebooks are insufficient as per Northern College’s BYOD policy.

  •  I understand the deadline to apply for CollegeBound is Thursday, August 21st, 2025.

No

Please list any accommodations you require:

______________________________________________

______________________________________________

I have read the information on this form, and by signing, I agree to the terms outlined above.

_________________________________________________

Your confirmation can be submitted in person, or by email .

Email: TimminsAccessibility@northern.on.ca

Please contact us if you require this form in an alternative format.

Source: https://www.northerncollege.ca/uploads/2025/07/CollegeBound-Timmins.pdf