Step 1 of 4 25% Unique IDThe Québec Board of Black Educators BANA Summer Institute 2021 program Registration PART 2: COURSE SELECTIONBANA Summer ProgramAre you registering more than one child for the BANA PROGRAM? If yes then you will need to register each child individually. After the first registration, you will need to enter in some information order to complete the second and third registrationsAre you registering more than one child for the BANA program?* Yes No Who is this registration for?Please ChooseMy first childMy second childMy third childAny child after the third is freePlease enter the name of the first child registered. Which grade level did you last complete?Please choose your grade levelGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Select the courses in order of priority that you require the most help*Scale: 1. Need the most help with 3. Need the least amount of helpEnglishFrenchMath BANA Fee Guide*If paying the first week, you will be responsible for paying the following weeks.BANA Weekly Fee Schedule June 28 - July 2 July 5 - July 9 July 12 - July 16 July 19 - July 23 July 26 - July 30 One Time Payment Additional note:BANA Weekly Fee Schedule June 28 - July 2 July 5 - July 9 July 12 - July 16 July 19 - July 23 July 26 - July 30 One Time Payment Additional note:BANA Weekly Fee Schedule June 28 - July 2 July 5 - July 9 July 12 - July 16 July 19 - July 23 July 26 - July 30 One Time Payment Additional note:BANA Weekly Fee Schedule* Free Additional note:I require an alternative fee schedule Yes Please do not select any dates above. To make payment arrangements, please call the program coordinator at 514-481-9400 or email her at barbara.asenso@qbbe.ca You must complete the registrationAre you interested in the Red Rush Basketball Program? Yes No Are you interested in daycare services? Yes, I need mornings Yes, I need evenings Yes, I need both Daycare FeesDaycare fees Select All One week Two weeks Three weeks Four weeks Five weeks CONTACT INFORMATIONStudent Information / Information étudiantWhich Organization referred you?*Please chooseMontreal Community CaresJamaican AssociationZimbabwean AssociationOn our own (O3)Women on the riseSchoolSocial MediaNone of the aboveName* First Name Last Name HiddenRegistration Email HiddenPortal Username Are you a returning student?* Yes, from the Fall session Yes, from past sessions No, I am new Address* #civic, street Apartment City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Date of Birth MM slash DD slash YYYY Gender* M F Any health conditions or allergies we should be aware of? Please list below. Documents upload(including Individual Education Plan (IEP), Report Card, Speech-Language Pathology Test, other relevant assessments) Drop files here or Select files Accepted file types: doc, docx, pdf, jpg, gif, png, Max. file size: 64 MB. Choose your school board*Choose your School Board-Central Québec School Board-Eastern Shores School Board-Eastern Townships School Board-English Montreal School Board-Lester B. Pearson School Board-New Frontiers School Board-Riverside School Board-Sir Wilfrid Laurier School Board-Western Québec School Board-Private School-Other-Commission Scolaire Marguerite-Bourgeoys-Commission Scolaire de Laval-Commission Scolaire des Laurentides-Commission Scolaire Marie-Victorin-Commission Scolaire de Montréal-Commission Scolaire de la Pointe-de-l'Île-Commission Scolaire de la Seigneurie-des-Mille-Îles- École privées-AutresSchool Cellular NoEmail address* CONTACT INFORMATION CONTINUEDParent Information:Parent* Father Mother Guardian Name* First Name Last Name Address same as student? Yes Address* #civic, street Apartment City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Cellular No.Email address* Add Another Parent/Guardian? Yes Parent* Father Mother Guardian Name* First Name Last Name Same address as above? Yes Address #civic, street / #civique, rue Apartment City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code (if different from the above one)Home Phone*Cellular No.Email address* HiddenPlease select your method of paymentIn PersonBy MailOnlineTotal $ 0.00 CAD PhoneThis field is for validation purposes and should be left unchanged.
