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St. Marys D.C.V.I.

Secondary

Student Agenda

2012 - 2013

St. Marys D.C.&V.I.

Box 970

St. Marys Ontario,

N4X 1B6

(519) 284-1731

In case of emergency, contact: _____________________________________

Relationship to student: __________________________________________

Telephone (Home): __________________ (Work): ____________________

Email Address (Parent): __________________________________________

I have read and I understand the contents of this agenda:

___________________________ __________________________

Student’s Signature Parent/Guardian Signature