DSBN Academy Student Application Form

Who can apply to attend DSBN Academy?

DSBN Academy is a grade 6 to 12 program designed to prepare and successfully transition students to post-secondary school, with a focus on students who will be the first in their families to graduate from college and university. Eligible students across Niagara may apply to DSBN Academy.

Please review the following checklist before completing this application:

Student must be entering grade 6, 7, or 8 in September. (Note: spaces are very limited in grades 7 and 8)
Student would be the first in their family to graduate from a college or university. If a sibling of the student has attended a post‐secondary institution but the parent(s)/guardian(s) have not, the student is still considered a First Generation Student.
Student must be willing to attend a school location that may be out of their community. Transportation will be provided for these students.
Student understands that there is a mandatory after‐school program that enhances the student experience beyond the classroom. These include enrichment opportunities and academic supports.

What is the admission process?

Complete each section of the application.
The Principal of the student's school will forward the application package to DSBN Academy.
The Application Review Committee will review the application package to determine eligibility. Please note that a lottery will be utilized if there are more eligible students than spaces available. Applicants not immediately selected for the program may be placed on a waiting list and will be considered if space becomes available.
Acceptance letters will be mailed to student address no later than March 31.

Section 1: Applicant Information

First Name

Middle Name

Surname

Date of Birth

Current Grade

Gender

Current Address

City

Postal

Home Phone

Current School (If attending Virtual School, please select student’s home school)

Current Principal

Section 2: Parent-Guardian Information

To be completed by parent(s) or guardian currently living with student applicant.

Student Applicant currently lives with (i.e., parent, guardian):

Parent / Guardian 1

First Name

Surname

Relation to Student

Work Phone

Cell Phone

Address (if different from the applicant)

* I have not graduated from College or University.

Parent / Guardian 2

First Name

Surname

Relation to Student

Work Phone

Cell Phone

Address (if different from the applicant)

I have not graduated from College or University.

Section 3: Student Response

Students are asked to answer in the space provided. Write your answers in complete sentences. Please provide examples to explain your answers to help us get to know you.

Question 1: Who or what inspires you to excel and be the best that you can be? Explain who you consider to be a good role model.

Question 2: Explain how you learn best as a student.

Question 3: Based on what you know about DSBN Academy, why do you want to attend?

Section 4: Parent / Guardian Response

Question 1: Explain the reasons why you would like your child to attend DSBN Academy.

Section 5: Conditions/Terms

To be completed by Parent/Guardian and Student

* I confirm that all the information in this application is accurate.

* I authorize DSBN staff and the DSBN Academy Selection Committee to access my child's Ontario Student Record (OSR) for the purposes of determining eligibility for the program and ongoing instruction in this program.

* I understand that my child will wear a uniform and follow all dress code requirements.

* I understand that my child’s attendance will be regular and consistent.

* As parent/gaurdian, I am aware that my child is to participate in the mandatory after school program.

* As parent/guardian, I have not graduated from college or university.