Youth Art + Culture Lab Registration Leave this field blank Student Information Parent / Guardian Information Information + Consents 1 Information + Consents 2 Student Information Legal First / Given Name Legal Family / Last Name Preferred Name Preferred Pronouns Address Line 1 Address Line 2 City Province / State Country Postal / Zip Code Student Email Address Program updates, class information and content from instructors will be sent to this address Student Phone Number Please provide a phone number to contact the student, other than the parent/guardian number provided Date of Birth YYYY/MM/DD e.g. 2008/10/24 School Grade Student's Grade as of September 1 2024 Grade 7Grade 8Grade 9 Gender Identity WomanManNon-BinaryChoose not to discloseNot specified I have taken or am currently taking courses at Emily Carr University. YesNo If yes, pease provide your Emily Carr Student ID number. Aboriginal Identity Voluntary DeclarationDisclosing your Aboriginal Identity is voluntary. Aboriginal refers to First Nations, Métis and Inuit peoples of Canada. Do you identify yourself as an Aboriginal person of Canada? YesNo Are you: Select all that apply. First NationsMétisInuit Are you: StatusNon-status Accessibility ServicesECU Accessibility Services provides supports to the learning environment for students with speech, hearing, visual, physical, mental health and neurological disabilities as well as chronic health conditions, acquired brain injury and temporary disabilities. If you would would like to access these services, Continuing Studies can direct your enquiry to Accessibility Services for a Student Resource Coordinator to contact you. Do you wish to be contacted by an Accessibility Coordinator? YesNoNot specified Next
