SVAE Application Form 533 A St. Anne’s Road, Winnipeg, MB, R2M 3E8 PH (204) 254-1618 ext. 200 or 206; FAX (204)255-2129 Revised May 2021 Name* First Middle Last Cell Phone:*Home / Alternative Phone:Email:* Enter Email Confirm Email What time of day do you prefer to be contacted? Date of Birth:* MM slash DD slash YYYY Part B: Educational Background1. What is the highest level of education that you have completed?* Did not complete High School High School Diploma Some College / University College Diploma Post-Secondary Certificate University Degree 1B. If you did not complete high school please fill out this section.If you have completed high school, please continue to question 2.What was the last grade completed?789101112Last High School Attended: Last Year Attended:2. How long has it been since you have attended a regular High School?* 5 or less years 6 to 10 year 11 to 20 years over 20 years 3. Why are you interested in taking courses at an adult learning centre?* Upgrading only (e.g., I need to take courses in order to enter a post-secondary institution) Mature Student High School Diploma (e.g., I have not completed my high school diploma) PART C: Courses of InterestReview the course list below and select all the courses that you would be interested in taking for upgrading purposes or to complete your Mature Student High School Diploma. Note: Not all courses are offered every school year.English English Comprehensive 30S English Comprehensive 40S English Transactional 30S English Transactional 40S Reading is Thinking Mathematics Math Essentials 30S Math Essentials 40S Applied Math 40S Pre-Calculus 30S Pre-Calculus 40S Science Biology 40S Chemistry 40S Physics 40S Electives (Optional Courses) Law 40S Psychology 40S Family Studies 40 Global Issues 40S Phys. Ed. 40S Applied Business Tech 40S Life/Work Transitioning 40S Community Service 40S CommentsThis field is for validation purposes and should be left unchanged.