District Career Education Program Application
-CONSTRUCTION ELECTRICIAN
To participate in this program:
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Students must have successfully completed all Grade 10 graduation credits by June of
2014.
Be 15 years of age or older
Be registered as a student in School District #43 (Coquitlam)
Have parent/guardian support and permission
Be responsible for his/her own transportation arrangements to the program site
(Dr.Charles Best)
Have an interest in learning more about an apprenticeable trade
Have a Social Insurance and a PEN Number
Meet academic requirements for entry into technical training at a post secondary
institution by the end of Grade 12
Meet the academic standards required in Construction Electrician (70% on the
industry certification exam)
Be willing to provide your own hard hat, and steel toe boots for Work Experience.
The cost of the program is approximately $250 which includes manuals, code book
usage, field trips and shop consumables.
If your application is accepted:
 I understand that my acceptance into this
program is contingent upon my completion
of the Package and a successful interview
with School District #43.
 I understand that I have the choice to
graduate with my peers from my previous
secondary school or I may choose to
graduate with my fellow Electricians from
Dr. Charles Best.
 I, along with my parent/guardian will attend
a Coquitlam School District meeting for all
students accepted in the Construction
Electrician program to discuss various
aspects of the program.
 I understand I will be covered by the
Workers Compensation Act for the dates and
times that I am placed with the employer.
 Will be offered an opportunity participate in a workplace based program during the summer of 2013.
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Signature of Student
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Signature of Parent/Guardian
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Signature of Counselor
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Signature of Administrator
 I will receive assistance from my Career Programs
Advisor and counselor to ensure I meet all program
requirements.
 I agree to conduct myself in a professional and
responsible way in the workplace.
Student Application Information
Student Name:
Birth Date:
Address:
Postal Code:
City:
School:
Grade:
Cell #
PEN #
Phone:
Email:
Check one: Yes 
No 
I hereby grant permission to Coquitlam School Board personnel to take photographs or video footage of
my son/daughter while on work experience. These pictures may be used in Career Programs publications,
newsletters, calendars and on the website at anytime for purposes of program promotion and celebration
of student successes.
Are you currently on an IEP?
If so please explain:
MEDICAL INFORMATION
Family Dr:
Circle One:
YES
NO
Address:
Phone:
Food Allergies:
Drug Allergies:
List all medical conditions:
List any injuries or illnesses affecting physical activity:
Have you been under a Dr’s care to ANY reason within the preceding 2 years? If so, explain
Are you currently on any medication? If yes, outline type, dosage & reason
Describe any medical/physical problems that might affect performance (i.e. epilepsy, diabetes, etc.)
Student Profile/Questionnaire
Please answer the following questions:
1. What are your long-range career goals?
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2. Why do you wish to take part in this program?
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3. What skills, talents, strengths and interests do you have that relate to the field of
becoming an electrician?
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4. What experiences have you had that lead you to feel this career is suited to your
personality style (volunteer experience, related jobs, extra curricular activities, etc.)?
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Student Application Requirements and Checklist:
Complete Student Application Information
Complete Student Profile/Questionnaire
Recent Resume is attached
School Reference Letter
Current Academic record showing completion of all prerequisites and/or Summer
School application completed to ensure completion of prerequisites are met
Documentation showing current attendance records
O:\Office Administrivia\TRANSITION TO TRADES APRIL 2006.doc