Heart Lake Secondary School
CO-OPERATIVE EDUCATION APPLICATION
Check your course selection:
o COP 2XC - 2 CREDITS
o COP 4XC - 4 CREDITS
**Please indicate if you are an SHSM student:
Arts/Culture ___ ICT___ NOT in SHSM ____
Congratulations on taking this very significant step in your career. Co-Op interviews for your work interests and career
goals will be held in May 2013 (for semester 1) and Nov 2013 (for semester 2). Start to prepare an “error proof” Resume
and visit the Co-Op site on Office 365.
RETURN THIS APPLICATION TO Room 113 (Co-Op Office) by October/March
Personal Information
Student Name:
ID #:
M or F
Home Phone:
Cell Phone:
DOB/Age:
Credits Earned to Date:
CIRCLE CAREER CHOICES YOU LIKE:
Aesthetics
Business
Child Care/Teaching
Computers (IT)
Entrepreneurship
Food Industry
Law
Logistics (Warehouse)
Medical & Health Clinics
Music & Arts Industry
OYAP (Ontario Youth Apprenticeships)
Retail
Sports/Athletics
Travel & Tourism
Trades – Specify____________________
Other (If you have your own placement, the company name here):_____________________________
OR CIRCLE CENTRAL OR REGIONAL PROGRAMS YOU LIKE:
These require specialized applications, essays, interviews, more commitment of your time & transportation costs. These
placements are subject to availability each semester and have a strict deadline!
Army Reserves (Sem 2 usually; sometimes Sem 1)
Brampton Fire/Life Safety Centre
City of Brampton – Parks and Rec, Animal Services, etc
Credit Valley Hospital
Donato Salon and Spa
Lexsan Industrial Electrical (Mississauga)
Mississauga News and Mississauga Business Times
Peel Regional Police
Region of Peel – Learn/Play/Care Centres
Rogers TV – Brampton and Mississauga
Spiegel Nichols Fox Law Firm
William Osler Health System – Caring for the Future
Dual Credit Programs
These programs are usually available in the Trades, ECE, Law and some Wellness programs but VARY every
year. They require attending a local community college (transportation is provided) to get a jump start on
College Courses while in high school. Please visit the following link for more info and speak to a co-op teacher
to determine availability: http://www1.peelschools.org/makingmyway/programs/DualCredits.htm
Transportation:
How far are you willing to travel for your placement? (Select One)
Anywhere in Brampton
Walking Distance Only
Mississauga
Anywhere in GTA
How will you get to your placement? (Select One – you are responsible for transportation!)
Walk
Brampton Transit
Drive Myself
Drive with Parent/Relative who works nearby
The more we know, the better we can match you to the perfect job! Please complete these questions.
1. List your skills, interests and extra-curricular experiences that you can offer to an employer.
_____________________________________________________________________________________
_____________________________________________________________________________________
2. Describe your volunteer activities or part-time jobs. ___________________________________________
___________________________________________________________________________________
3. List Awards/Certificates of Achievement you have earned, both in and out of school, in sports, academics,
attendance, Driver’s Ed, martial arts, dance, etc. ______________________________________________
____________________________________________________________________________________
4. How is your attendance? (Circle one)
How is your punctuality?
Excellent
Good
Fair
Could be better
Excellent
Good
Fair
Could be better
5. When do you expect to graduate with 30 credits? (Month, Year) ________________________________
6. What are your plans after you graduate? (Circle one)
College
University
Work
7. Why do you want to take Co-Op, or what do you hope to learn from it? ___________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________________
References: List ONE teacher reference and have them sign below:
Teacher’s Name (print)
Teacher’s Signature
______________________________
______________________________
**Comments:
Approval: PARENTS/GUARDIANS SHOULD BE AWARE THAT EACH STUDENT:
1.
2.
3.
4.
Will be interviewed by the Co-Op teacher and prospective employer
Is encouraged by the Peel District School Board to use public transportation to and from the placement
If own (personal/family) vehicles are used:
-the student must have the appropriate classification of driver’s license and car insurance
-the primary insurer is the owner’s insurance
-the insurer of the vehicle must respond to any insurance claim
Will be covered, while at the co-op placement, under the Workers’ Compensation Act by WSIB
I am aware that the information contained in this application will be used for purposes consistent with the Education Act
____________________________________________
Student’s Signature
____________________________
Date
____________________________________________
Parent/Guardian’s Signature (REQUIRED If under 18)
_____________________________
Date