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Grade 12
Headwaters Application
Thank you for your interest
in the Grade 12 Headwaters
Program. For more information
on the program and on the
application process, please
go to www.celp.info.
To sign up for Headwaters, please consult your guidance
department about what courses to submit. The course
codes for Headwaters are:
CGR 4MKThe Environment and Resource Management
ENG 4UK University English
PAD 4OK Outdoor Activities
IDP 4UK Interdisciplinary Studies
There are three parts to the application:
1
Student information
– This gives us basic
information about how to
contact you.
n
2
3
Application
Separate document:
questions – This
A teacher reference
allows us to assess whether form – Please email the
you will be a good fit for
teacher reference form
the program.
to one of your Grade 11
teachers. This gets emailed
or mailed directly to us.
Email your application to katie.gad@ugdsb.on.ca
Due on the deadline for course selection at your school.
Students will be notified in early April by email if they are accepted into the program.
Grade 12 Headwaters Application
Student information
Name (first and last):
Home School:
1
Gender:
Present Grade:
Student Email (will be used to send acceptance):
Parent Email (will be used to notify of parent meeting):
Name of Teacher Reference:
Home Phone:
Currently, Headwaters is only offered in Semester 2. If enough students apply, it is possible that that this program
may run in Semester 1 as well.
Would you be able to take Headwaters in Semester 1 if it is offered? Yes No
If Headwaters is offered both semesters, do you have a preference of which semester you would want to be in?
Please explain your rationale below:
More questions on next page
For staff use only:
Student Information Page
Application Questions
Teacher Reference
Grade 12 Headwaters Application
Application Questions
2
Don’t forget to e-mail the teacher reference form to one of your grade 11 teachers
You can answer these in question-and-answer format or in a single page of writing
paragraph style (boxes will scroll to accommodate your text). If you prefer, you can
also respond to them by creating a picture, mind map or spoken word piece. Please
scan and attach any images or sounds to your email application.
1) How did you hear about Headwaters and how would you describe the program in two to three sentences?
2) What do you hope to gain from taking Headwaters for the semester?
3) How would you describe your typical role in group work situations?
4) What skills, experience and characteristics would you contribute to a Headwaters community?
5) How will the Headwaters learning environment fit with your learning style?
6) Is there anything else you would like us to know about you?
Save your PDF with the student’s name as the file name and email as an
attachment to katie.gad@ugdsb.on.ca or please return directly to Guidance.
Due on the deadline for course selection at your school.