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1 | P a g e CPF PEI Provincial Concours d’art oratoire 2015 Official Student Registration Form Saturday April 18, 2015 at UPEI The information provided will be used for the purposes of registering for the CPF PEI Concours d’art oratoire 2015. All entries must be completed in full by the person named on the entry form. STUDENT INFORMATION Last Name: First Name:
Mailing Address (City/Town): Home Phone + area code: Cell Phone + Area Code:
Age:
Date of Birth: Province:
Postal Code: E‐mail Address:
Title of speech: School Name Phone; Fax: Teacher’s name E‐mail Address (Teacher’s):
STUDENT EDUCATIONAL INFORMATION In which grade and program are you currently enrolled? Core French/ Basic French  11  12  10 Core Extended/ Enriched/ Advanced  11  12  10 Early Immersion
 11  12 Late Immersion
 11  12 Francophone
 11  12  10  10  10 2 | P a g e CPF PEI Provincial Concours d’art oratoire 2015 Official Student Registration Form LINGUISTIC EXPERIENCES (PLEASE CHECK OFF THE APPROPRIATE BOXES BELOW) 1.
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What is your first language (Mother tongue)?  English  French  Other If your mother tongue is not one of Canada’s official languages, which Canadian official language did you learn first?  English  French  Yes  No Are you from a home in which a parent speaks in French regularly? Are you from a home in which one or both parents can speak French as a second language?  Yes
 No How often is French spoken in your home?  Always  Often  Sometimes  Never Where you ever part of a student exchange program in a milieu where French was spoken regularly?  Yes  No If yes, which country/ province? ____________________________________________________________________________ How long was the program? ____________________________________________________________________________ How recent was your linguistic experience? __________________________________________________________________ (Please specify with dates) By signing below, you acknowledge that your speech is your and violates no copyrights, and that if you are a finalist or winner, you give permission for your speech to be used in whole or in part to promote CPF and future CPF contests. I hereby certify that this entry is entirely my original work. I also hereby grant permission to CPF to publish my speech on its website and in other publications for publicity purposes only. I hereby certify that the information contained in this registration form is accurate, and I accept that decisions taken by CPF are finial. Date (Print) Parent/ Guardian Name
Date Parent/ Guardian Signature
(Print) Participant Name
Participant Signature
Deadline to enter is Friday April 11, 2015. Fax to 628‐8062 or email to concours@cpfpei.pe.ca or call Gail at 368‐
3703.