Alberta Distance Learning Centre

PROVINCIAL DIPLOMA EXAMINATION PROCEDURES FOR DISTANCE LEARNING STUDENTS

2009-2010

TABLE OF CONTENTS
Diploma Examination Procedures.......................................................................3

Grade 12 Diploma Schedule ............................................................................ 5-7

Writing Centres............................................................................................... 8-10

Communications - Print and Web Documents .................................................11

Transcripts and Fees...........................................................................................11

Accommodations - Special Needs ......................................................................12

ADLC - Other Important Information .............................................................13

Every effort has been made to ensure that the information contained in this booklet is accurate at the time of publication. Alberta Distance Learning Centre has no obligation to provide additional notice to students should diploma examination policies or dates of administration of diploma examinations be changed by the Learner Assessment Branch. Students may conrm examination dates by telephone: Phone toll-free at 1-866-774-5333 ext. 5255. Check Alberta Education's website for updates: http://education.alberta.ca/admin/testing/diplomaexams.aspx.

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2009-2010
ALBERTA DISTANCE LEARNING CENTRE DIPLOMA EXAMINATION PROCEDURES FOR SENIOR HIGH STUDENTS
Print and Online

Step One:

Choose the course and diploma sitting in which you are interested. (pp. 5-7)

Step Two: Find the form that applies to your situation. Step Three: Complete the required personal information portion of the application form. Then take the form to the school where you are writing the exam to have the school's information added. If you are writing at 44 Capital Blvd. Building (10044 - 108 Street, 6th oor) in Edmonton, or the Financial Buidling in Edmonton, or SAIT in Calgary, the school portion should be ignored. Step Four: Send the completed form to ADLC for processing.

*Special Writing Centres are established only for out-of-province students and only for January, June, and August. Rewrites are possible only if you have written the diploma exam within the last two years. Accommodations may be made for students with special needs if a request form is completed by the school. Medical documentation must be attached. Students with special needs must contact us immediately. (Toll-free: 1-866-774-5333 ext. 5255) This information is subject to change by Alberta Education. Please access Alberta Education's website at http://education. alberta.ca/admin/testing/diplomaexams.aspx to conrm dates and writing centres.

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Grade 12 Diploma Examination Schedule 2009 - 2010 School Year

The grade 12 diploma examinations must be administered according to the dates and times indicated in this schedule. Adjustments may not be made to examination starting times. All Part (ie) B examinations are secured. NOVEMBER 2009
Tuesday, November 3

[ADLC ofces only]

(Registration deadline is September 30, 2009)

English Language Arts 30-2 Part A English Language Arts 30-2 Part B Pure Mathematics 30 Chemistry 30 (New Program Only) Physics 30 (New Program Only)

9:00 to 11:30 a.m. 1:00 to 3:30 p.m.

Wednesday, November 4 Thursday, November 5 Friday, November 6

1:00 to 3:00 p.m. 1:00 to 3:00 p.m. 1:00 to 3:00 p.m.

JANUARY 2010 (Dates Revised November 2009) (Registration deadline is November 2, 2009)
Thursday, January 14 Friday, January 15 9:00 to 11:30 a.m. 9:00 to 11:00 a.m. 9:00 to 11:30 a.m. 9:00 to 11:00 a.m. 9:00 to 11:00 a.m. 9:00 to 11:30 a.m. English Language Arts 30-1 Part A English Language Arts 30-2 Part A Social Studies 30 Part(ie) A Social Studies 30-1 Part(ie) A Social Studies 33 Part(ie) A Social Studies 30-2 Part(ie) A Franais 30-1 Partie A French Language Arts 30-1 Part A Chemistry 30 (Old Program) Part(ie) A Chemistry 30 (New Program) Chemistry 30 (Old Program) Part(ie) B Applied Mathematics 30 Pure Mathematics 30 Franais 30-1 Partie B French Language Arts 30-1 Part B Biology 30 English Language Arts 30-1 Part B English Language Arts 30-2 Part B Social Studies 30 Part(ie) B Social Studies 30-1 Part(ie) B Social Studies 33 Part(ie) B Social Studies 30-2 Part(ie) B Physics 30 (Old Program) Part(ie) A Physics 30 ((New Program) Physics 30 (Old Program) Part(ie) B Science 30

Monday, January 18

D ISE EV S R TE DA

Thursday, January 21

9:00 to 10:00 am. 9:00 to 11:00 am. 1:00 to 3:00 pm. 9:00 to 11:00 a.m.

Friday, January 22

Monday, January 25

9:00 to 11:00 a.m. 9:00 to 11:30 a.m. 1:00 to 3:00 p.m. 9:00 to 11:30 a.m.

Tuesday, January 26

Wednesday, January 27

9:00 to 11:00 a.m.

Thursday, January 28

9:00 to 10:00 a.m. 9:00 to 11:00 a.m. 1:00 to 3:00 p.m.

Students are permitted an additional one-half hour to complete their exams.

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Grade 12 Diploma Examination Schedule 2009- 2010 School Year (continued)

The grade 12 diploma examinations must be administered according to the dates and times indicated in this schedule. Adjustments may not be made to examination starting times. All Part (ie) B examinations are secured. APRIL 2010
Monday, April 12 Tuesday, April 13

[ADLC ofces only]

(Registration deadline is March 4, 2010)

English Language Arts 30-1 Part A English Language Arts 30-1 Part B Social Studies 30-1 Part(ie) A Social Studies 30 Part(ie) A Social Studies 30-2 Part(ie) A Social Studies 33 Part(ie) A Social Studies 30-1 Part(ie) B Social Studies 30 Part(ie) B Social Studies 30-2 Part(ie) B Social Studies 33 Part(ie) B Biology 30

9:00 to 11:30 a.m. 1:00 to 3:30 p.m. 9:00 to 11:30 a.m. 9:00 to 11:00 a.m.

1:00 to 3:00 p.m.

Wednesday, April 14

9:00 to 11:00 a.m.

ED VIS RE ES T DA

JUNE 2010 (Dates Revised November 2009)

Monday, June 14

(Registration deadline is April 14, 2010)

English Language Arts 30-1 Part A English Language Arts 30-2 Part A Social Studies 30 Part(ie) A Social Studies 30-1 Part(ie) A Social Studies 33 Part(ie) A Social Studies 30-2 Part(ie) A Franais 30-1 Partie A French Language Arts 30-1 Part A Chemistry 30 (Old Program) Part(ie) A Chemistry 30 (New Program) Chemistry 30 (Old Program) Part(ie) B Applied Mathematics 30 Pure Mathematics 30 Franais 30-1 Partie B French Language Arts 30-1 Part B Biology 30 English Language Arts 30-1 Part B English Language Arts 30-2 Part B Social Studies 30 Part(ie) B Social Studies 30-1 Part(ie) B Social Studies 33 Part(ie) B Social Studies 30-2 Part(ie) B Physics 30 (Old Program) Part(ie) A Physics 30 (New Program) Physics 30 (Old Program) Part(ie) B Science 30

9:00 to 11:30 a.m.

Tuesday, June 15

9:00 to 11:00 a.m. 9:00 to 11:30 a.m. 9:00 to 11:00 a.m. 9:00 to 11:00 a.m 9:00 to 11:30 a.m.

Wednesday, June 16

Thursday, June 17

9:00 to 10:00 a.m. 9:00 to 11:00 am. 1:00 to 3:00 p.m. 9:00 to 11:00 am.

Friday, June 18

Tuesday, June 22

9:00 to 11:00 a.m. 9:00 to 11:30 a.m. 1:00 to 3:00 p.m. 9:00 to 11:30 a.m. 9:00 to 11:00 a.m.

Wednesday, June 23 Thursday, June 24

Friday, June 25

9:00 to 10:00 a.m. 9:00 to 11:00 a.m. 1:00 to 3:00 p.m. Page 6

Students are permitted an additional one-half hour to complete each exam.

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Grade 12 Diploma Examination Schedule 2009- 2010 School Year (continued)

The grade 12 diploma examinations must be administered according to the dates and times indicated in this schedule. Adjustments may not be made to examination starting times. All examinations are secured.

AUGUST 2010

(Summer School Students - Registration deadline is July 5, 2010) Walk in students must arrive at least 30 minutes prior to the examination time. 9:00 to 11:30 a.m. English Language Arts 30-1 Part A English Language Arts 30-2 Part A English Language Arts 30-1 Part B English Language Arts 30-2 Part B Social Studies 30 Part(ie) A Social Studies 30-1 Part(ie) A Social Studies 33 Part(ie) A Social Studies 30-2 Part(ie) A Social Studies 30 Part(ie) B Social Studies 30-1 Part(ie) B Social Studies 33 Part(ie) B Social Studies 30-2 Part(ie) B Applied Mathematics 30 Pure Mathematics 30 Chemistry 30 (Old Program) Part(ie) A Chemistry 30 (Old Program) Part(ie) B Chemistry 30 (New Program) Biology 30 Physics 30 (Old Program) Part(ie) A Physics 30 (New Program) Physics 30 (Old Program) Part(ie) B Science 30 Franais 30-1 Partie A French Language Arts 30-1 Part A Franais 30-1 Partie B French Lanuage Arts 30-1 Part B

Wednesday, August 4

1:00 to 3:30 p.m.

Thursday, August 5

9:00 to 11:00 a.m. 9:00 to 11:30 a.m. 9:00 to 11:00 a.m. 9:00 to 11:00 a.m. 1:00 to 3:00 p.m.

Friday, August 6

9:00 to 11:00 a.m. 9:00 to 10:00 a.m. 1:00 to 3:00 p.m.

Monday, August 9 Tuesday, August 10

9:00 to 11:00 a.m. 9:00 to 10:00 a.m. 9:00 to 11:00 a.m. 1:00 to 3:00 p.m.

Wednesday, August 11

9:00 to 11:30 a.m.

1:00 to 3:00 p.m. 1:00 to 3:30 p.m.

Students are permitted an additional one-half hour to complete each exam.

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Writing Centres for the 20092010 School Year

January 2010 and June 2010 Examinations These diploma examinations are administered in all accredited Alberta high schools that offer Grade 12 diploma examination courses. ADLC diploma students may choose to write at any such high school or one of the writing centres listed below. Please contact our Exams department for more information [toll-free: 1-866-774-5333, then ext. 5255]. Please note: There are a limited number of computers available for ADLC students to complete their diploma examinations at our writing centres at SAIT in Calgary and at our Lethbridge ofce. To book a computer at SAIT, please contact our Calgary ofce. To book a computer in Lethbridge, please contact the Lethbridge ofce. ADLC Writing Centres (November, January, April, and June) Barrhead - ADLC Main Ofce (4601-63 Ave.) ......................................................... [School Code - 0099] Beaverlodge - Beaverlodge Regional High School ................................................... [School Code - 1101] Calgary - SAIT (1301-16 Ave. NW) .......................................................................... [School Code - 9996] Edmonton - January and June ................................................................................. [School Code - 0318] 44 Capital Blvd. Building, 6th oor (10044 - 108 St.) Edmonton - November, April, and August ................................................................ [School Code - 1223] Financial Building, 8th oor (10621-100 Ave.) Lethbridge - November and April ............................................................................. [School Code - 0099] ADLC Regional Ofce Palliser Education Centre (3305-18 Ave. North)

August 2010 Examinations These diploma examinations are administered in the writing centres listed in this section. In most cases, summer school students write their examinations at their summer schools. Writing centres in Northwest Territories are designated as needed. Please contact Northwest Territories Education at 867-920-6235. Writing centres in Nunavut are designated as needed. Please contact Nunavut Department of Education at 867-975-5658.

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Writing Centres for the 2009- 2010 School Year (continued)

SUMMER SCHOOL AND WALK-IN STUDENTS ONLY
School Code
2601 2316 2950 6718 9996 4504 5725 1223 1857 1141 1715 2011 2702 6466 6850 1511 4444 3610 3909 3144 Athabasca Barrhead Bonnyville Brooks Calgary Camrose Drumheller Edmonton Fort McMurray Grande Prairie High Level Hinton Lac La Biche Lethbridge Medicine Hat Peace River Red Deer Vegreville Wainwright Wetaskiwin

Writing Centres - August 2010

Edwin Parr Composite Community School Vista Outreach, 4923 - 50 Avenue Bonnyville Centralized High School Brooks Composite High School SAIT (Location to be announced at a later date) PACE Outreach School Drumheller Composite High School Financial Building, 10621 - 100 Avenue (8th Floor) Fort McMurray Composite High School Grande Prairie Composite High School High Level Learning Store Harry Collinge High School J.A. Williams High School Winston Churchill High School Medicine Hat High School Peace River High School Lindsay Thurber Composite High School Vegreville Composite High School Wainwright High School Wetaskiwin Composite High School

Writing centres in Northwest Territories are designated as needed. Please contact Northwest Territories Education at 867-920-6235. Writing centres in Nunavut are designated as needed. Please contact Nunavut Department of Education at 867-975-5658.
NOTE A: All students not registered through a summer school program must register as walk-in candidates at

the time of their examination(s) and also pay their rewrite fee (if applicable). Walk-in students should arrive at a writing centre at least thirty minutes before the published examination start time to complete registration requirements. At the time of writing, walk-in students must present appropriate identication that includes a photograph and a signature prior to being permitted to write the examination.
NOTE B: To request the use of a computer to write Part(ie) A of a Social Studies, English Language Arts, Franais, French Language Arts, or Biology 30 diploma examination, contact the writing centre at which you plan to write prior to June 30, 2010. Please note some writing centres may not be able to accommodate your request.

Please access Alberta Education's website at http://education.alberta.ca/admin/testing/diplomaexams.aspx to conrm dates and writing centres.

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Special Writing Centres

Students on vacation or on an organized tour are not eligible to write diploma examinations outside of Alberta. Students outside the province of Alberta during the January, June, and August diploma examination administrations may be permitted to write at a special writing centre if they are participating in an activity such as a national or international competition in athletics or music they live outside the province and are taking courses through the Alberta Distance Learning Centre after taking instruction at an accredited high school in Alberta, they have permanently or temporarily moved outside the province and are unable to write the examination in Alberta a supervising examiner acceptable to the Director, Examination Administration for the Learner Assessment Branch, is available to administer the examination. The supervising examiner could be, for example, a school principal, a teacher, a police ofcer, or a commissioned military ofcer. The supervising examiner may not be a relative of or a past or present teacher of the student or reside with the student. Students who qualify may apply to write at a special writing centre by completing the Application to Establish a Special Writing Centre form (see Forms and Samples) or by sending a letter of application to the Coordinator, Special Cases Accommodations. Requests made by letter must include the information requested on the application form.

Students who intend to rewrite a diploma examination at a special writing centre must also submit a completed Diploma Examination Registration and/or Rewrite Fee Form (see Forms and Samples) and the examination rewrite fee, if applicable. Education requires that all students write their Grade 12 diploma examinations at an accredited high school or a provincially designated writing centre. Students are responsible for costs incurred to establish a special writing centre, to administer an examination at a special writing centre, and to return the examination to the Learner Assessment Branch by courier. Please access Alberta Education's website at http://education.alberta.ca/admin/testing/diplomaexams.aspx to conrm dates and writing centres.

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CommunicationsPrint and Web Documents

Subject Information Bulletins The Grade 12 diploma examinations are based on the provincially prescribed Programs of Study. At the start of each school year, the Learner Assessment Branch makes available subject information bulletins containing descriptions of diploma examinations and any changes to their format, subject matter, or scoring criteria. Subject information bulletins are available on the Alberta Education website at http://education.alberta.ca/admin/ testing/diplomaexams.aspx. School administrators should ensure that students and teachers have access to the information in these bulletins.

General Information Bulletin This bulletin contains information on examination schedules and signicant dates in the 20092010 school year policies and procedures on such things as security, registration on walk-in students, administration procedures, plus many more forms and samples and registration information marks, results, and appeals. The General Information Bulletin is available on the Alberta Education website at http://education.alberta.ca/admin/testing/diplomaexams.aspx.

Other Important Information The Alberta Education website http://education.alberta.ca/admin/testing/diplomaexams.aspx contains information for students in addition to the above noted. These documents are also available through your schools. These include Projects for Pure and Applied Mathematics Guides for Students Data Booklets Previous Diploma Examinations and Answer Keys

TRANSCRIPTS: Students who attended high school in Alberta may wish to contact Alberta Education Information and Transcripts Unit for information on provincial diploma requirements, a copy of their high school transcript, or transcript request forms. The address and phone number for transcript requests is Transcript Unit, Alberta Education 44 Capital Boulevard, 10044 - 108 Street, 2nd oor, Edmonton, AB T5J 5E6. Phone toll-free: 310-0000, then 780-427-5732. Transcripts can be requested online at http://www.education.gov.ab.ca/learning studentservices/.

ADLC TRANSCRIPT FEE: Alberta Distance Learning Centre evaluates records of students who have studied outside Alberta only if they are registered with ADLC in a program. Ofcial documents showing your scholastic record should be sent to the Senior High Counsellor, Alberta Distance Learning Centre, Box 4000, Barrhead, Alberta, T7N 1P4, for evaluation. You will be informed of the standings assigned to you toward a high school diploma in Alberta. A Transcript Fee of $75 is charged for this evaluation, and you must forward ofcial statements in English of all completed high school courses. In some situations, course descriptions must be provided before an evaluation can be completed. You can go to ADLC's counselling webpage at http://www.adlc.ca/content/blogcategory/22/63/ for further details.
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Accommodations for Students with Special Diploma Examination Writing Needs

Alberta Education has approved the accommodations listed below for students with special diploma examination writing needs. Phone our Senior High School Counsellor concerning these accommodations. Dial toll-free 1-866-774-5333. Accommodation 1: CD version for students with visual impairment Accommodation 2: CD version for students with learning or physical disability Accommodation 3: additional writing time Accommodation 4: word processor Accommodation 5: scribe Accommodation 6: large-print version Accommodation 7: Braille version Accommodation 8: reader Accommodation 9: sign language interpreter Accommodation 10: taped response Accommodation 11: miscellaneous (Please specify on Principals/Chief Presiding Examiners Statement) Note: Please use the appropriate accommodation number to indicate the accommodation requested on the Application for Accommodations. Also, mark on the students answer sheet the accommodation(s) used by the student.

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ALBERTA DISTANCE LEARNING CENTRE Other Important Information

Alberta Distance Learning Centre Senior High Registration Guide 2009-2010 contains other important information for diploma students, including Alberta High School Graduation Requirements.

Studying: ADLC has provided an optional Internet resource for diploma exam study at www.exambank.com.
Please contact your ADLC teacher for a username and password.

ADLC Website Updates: The Registration Guide and all other information are updated regularly on the ADLC website. To obtain the most up-to-date information, please go to the Registration guides website at http://www.adlc.ca/component/option,com_docman/task,cat_view/gid,17/Itemid,119/order,name/dir,ASC/.

Final Marks: To be eligible for credit in English 30-1, English 30-2, Social Studies 30,
Social Studies 33, Pure Mathematics 30, Applied Mathematics 30, Biology 30, Chemistry 30, Physics 30, and Science 30, students must write the appropriate diploma examination and attain a nal blended mark of 50% or higher. To obtain credit for these courses, students must complete both Parts A and B of the diploma examination within the same administration period. In addition to the diploma examination, students must also write a nal exam set by Alberta Distance Learning Centre to qualify for the school-awarded portion of their mark. Mature students do not require a school-awarded mark. If adults have a school-awarded mark, Alberta Education grants the higher of the diploma exam or the blended mark as the nal course mark.

Contact Information - ADLC Exams Department

If you have any questions or need more information, please contact Alberta Distance Learning Centre Exams Department in Barrhead, toll-free at 1-866-774-5333, ext 5255.

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Registration and Rewrite Forms for January, June, April, and August

Diploma Examination Registration Form 20092010 (January, June and August)

Note: If you are rewriting the examination(s) for which you are registering, you must also submit a Diploma Examination Rewrite Fee Form and the rewrite fee. The personal information collected on this form will be used by Alberta Education for examination registration purposes only.
ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES OTHER NAME(S) KNOWN BY
Year Month Day

BIRTH DATE (e.g., 91 Jul 20) PERMANENT ADDRESS

Apt/Street/Ave/P.O. Box/Route

SEX

MMale FFemale

TELEPHONE

Village/Town/City

Province

Postal Code

Diploma Examination(s) To Be Written

English French

January

Administration Session June

August

Applied Mathematics 30 Biology 30 Chemistry 30 (Old) Chemistry 30 (New) English Language Arts 301 English Language Arts 302 Franais 301 French Language Arts 301 Physics 30 (Old) Physics 30 (New) Pure Mathematics 30 Science 30 Social Studies 30 Social Studies 33 Social Studies 301 Social Studies 302
Notes: To request the use of a computer to write diploma examinations, you must contact the principal of the school at which you intend to write well in advance of the writing date. Some schools may not be able to accommodate your request. If you require accommodations for the writing of a diploma examination you must complete the Application for Accommodations form by the deadline date.

Are you currently receiving course instruction for the diploma examination(s) you will be writing/rewriting? No If yes, name of the school Yes Writing centre where you intend to write the examination(s): Writing Centre Name: Writing Centre Principals Signature (if applicable) Diploma examination registration deadline, by session: January 2010 session: November 2, 2009 June 2010 session: April 14, 2010
This form must be submitted to: Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977
JJ

Writing Centre Code:

FOR OFFICE USE ONLY

August 2010 session: July 5, 2010

Phone: (780) 674-5333 ext. 5255

Toll Free: 1-866-774-5333

Alberta Education

September 2009

April 2010 Diploma Examination Registration Form 20092010

Note: If you are rewriting the examination(s) for which you are registering, you must also submit a Diploma Examination Rewrite Fee Form and the rewrite fee. The personal information collected on this form will be used by Alberta Education for examination registration purposes only.
ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES OTHER NAME(S) KNOWN BY
Year Month Day

BIRTH DATE PERMANENT ADDRESS

Apt/Street/Ave/P.O. Box/Route

SEX

MMale FFemale

TELEPHONE

(e.g., 91 Jul 20)

Village/Town/City

Province

Postal Code

April Diploma Examination(s) English Language Arts 30-1 Social Studies 30-1 Social Studies 30-2 Social Studies 30 Social Studies 33 Biology 30

Notes: To request the use of a computer to write diploma examinations, you must contact the principal of the school at which you intend to write well in advance of the writing date. Some schools may not be able to accommodate your request. If you require accommodations for the writing of a diploma examination you must complete the Application for Accommodations form by the deadline date.

Are you currently receiving course instruction for the diploma examination(s) you will be writing/rewriting? Yes No If yes, name of the school Writing centre where you intend to write the examination(s): Writing Centre Name: Writing Centre Principals Signature (if applicable) Diploma examination registration deadline, by session: January 2010 session: November 2, 2009 June 2010 session: April 14, 2010 August 2010 session: July 5, 2010 Writing Centre Code:

This form must be submitted to: Alberta Distance Learning Centre Box 4000 Barrhead AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

Alberta Education

September 2009

Diploma Examination Rewrite Fee Form 20092010

NOTE: This form is for the payment of rewrite fees only. If you have not been registered to rewrite the diploma examination by your school, you must submit a Diploma Examination Registration Form to register for the examination(s) you intend to rewrite.

The personal information collected on this form will be used by Alberta Education for rewrite fee payment purposes only.
ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES OTHER NAME(S) KNOWN BY BIRTH DATE PERMANENT ADDRESS

Year

Apt/Street/Ave/P.O. Box/Route

(e.g., 91 Jul 20)

Month

Day

SEX

MMale FFemale

TELEPHONE

Village/Town/City

Province

Postal Code

Examination(s) for which rewrite fees are being paid:

Applied Mathematics 30 Biology 30 Chemistry 30 (Old) Chemistry 30 (New) English Language Arts 301 English Language Arts 302 Franais 301 French Language Arts 301 Physics 30 (Old) Physics 30 (New) Pure Mathematics 30 Science 30 Social Studies 30 Social Studies 33 Social Studies 301 Social Studies 302

I am submitting payment for the rewriting of diploma examination(s) at $26.25 each, for a total of: $ Method of Payment Cheque/Money Order (made payable to the Minister of Finance) Cash Debit Card Credit Card Do not send cash by mail or postdate cheques or money orders Visa Master Card Cardholders name as printed on credit card (please print): Cardholders Signature: Card Number: Expiry Date: Submit this form and the rewrite fee(s) in person at or by fax or mail to: Alberta Distance Learning Centre Box 4000 Barrhead AB T7N 1P4 Fax: (780) 674-6977
Notes:

Phone: (780) 674-5333 ext. 5255

Toll Free: 1-866-774-5333

Rewrite fees are only required to be paid when rewriting examinations that were previously written on or after September 1, 2007. If you have an unpaid rewrite fee from a prior examination session, your current payment will be credited toward the outstanding debt. You must clear any outstanding debt before current examination marks will appear on your high school record. If you register to rewrite an examination(s) and cancel or do not write it after submitting a rewrite fee payment, a $10.50 processing fee will be charged for each examination that is not written. Only the remaining rewrite fee monies will be refunded upon request.

Alberta Education

September 2009

Special Diploma Exam Forms

Application for Accommodations for Students with Special Diploma Examination Writing Needs 20092010
ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES
Year Month Day

For Learner Assessment Use Only Approved Signature Denied

BIRTH DATE (e.g., 91 Jul 20) PERMANENT ADDRESS

Apt/Street/Ave/P.O. Box/Route

SEX

MMale FFemale

TELEPHONE

Village/Town/City

Province

Postal Code

E-MAIL ADDRESS

This student is currently registered with Alberta Education with a Special Education Student Code: If yes, indicate coding

Yes

No

If the student does not have a Special Education Student Code, the results of a formal assessment completed by a qualified professional must be submitted. If the section below is completed and the results of a formal assessment are submitted, there is no need to submit the Individual Program Plan (IPP) or description of accommodations. If you are waiting for assessment and/or supplementary information, please ensure the application is submitted by the deadline date and forward assessment and/or supplementary information as soon as it becomes available. Note: Please use the ESL Application for Accommodations for Diploma Examinations form when applying for an extra time accommodation for ESL and Francisation students (see Special Cases & Accommodations and Examination Administration Forms sections of the General Information Bulletin). If the student is registered at Alberta Education with a Special Education Student Code, please check which accommodations are currently included in the students IPP and being provided and used:
No. 1 No. 2 No. 3 No. 4 No. 5 No. 6 CD for Visually Impaired Students CD for Students with Learning or Physical Disability Extra Time Not currently assigned Scribe Large print (20-point font) No. 7 No. 8 No. 9 No. 10 No. 11 No. 16 Braille Reader Sign Language Interpreter Taped Response Franklin Language Master Miscellaneous, please specify

I attest that the information provided above is true:

Staff member name, title, signature; date

Name and school code of the writing centre where this student intends to write.
Writing Centre Name School Code:

Examination administration session for which this request applies (use a separate application form for each session): November 2009; deadline for application: September 30, 2009 January 2010; deadline for application: November 6, 2009 April 2010; deadline for application: March 3, 2010 June 2010; deadline for application: April 16, 2010 August 2010; deadline for application: July 16, 2010

Page 1 of 2

Alberta Education

September 2009

Application for Accommodations for Students with Special Diploma Examination Writing NeedsContinued
ALBERTA STUDENT NUMBER STUDENTS NAME

Indicate the course(s) and accommodation(s) requested by referencing the list of accommodations on page 1 of this application. Indicate the number of each accommodation requested as well as if they are to be in French or English. Accommodations
English French Biology 30 Course
2-CD 3-Extra Time 6-Large Print

English

French

English

French

English

French

English

French

English

French

Course

Course

Course

Course

Course

Note: Please specify the specific course name of the examination for which you are requesting accommodation(s) e.g., English Language Arts 301; Chemistry 30 (New). If requesting different accommodations for the part(ie) A and part(ie) B sections of a Humanities examination, specify the accommodations for each part in a separate column e.g. Social 30 Part A; Social 30 Part B.

To be completed by the principal or principals delegate of the Alberta high school the student is attending: School Code Principals Name School E-mail Address Principal/Designate Signature Second Contact Name and E-mail Address To be completed by student and parent/guardian: I/we understand that the personal information collected on this form pursuant to section 32(c) of the Freedom of Information and Protection of Privacy Act will be used to process and administer the writing and/or rewriting of the registered diploma examination(s) and/or for making the appropriate adjustment of marks in the registered subject(s). This information will be used for the purposes stated, by Alberta Education only. I/we have accurately provided information on this application form.
Signature of Student Date

School Name School Telephone

Area Code

Fax Number
Area Code

Date

Signature of Parent/Guardian (if student is under 18 years of age)

Date

Failure to submit the completed application and appropriate documentation by the deadline specified on the first page of this form, will result in the application being denied.

This form must be submitted to: Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

Alberta Education

Page 2 of 2

September 2009

Application to Establish a Diploma Examination Special Writing Centre 20092010

ALBERTA STUDENT NUMBER BIRTH DATE
(e.g. 90 Jul 20 Year Month Day

SEX
M/F

TELEPHONE For Office Use Only

SURNAME LEGAL FIRST AND MIDDLE NAMES

Approved

Denied

_______________________ Signature

E-mail ADDRESS

Note:

For this form to be processed, a completed Application to Supervise a Diploma Examination Special Writing Centre form must also be submitted.

1.

Proposed location of and reason for requesting approval to establish a Special Writing Centre:

2.

Examination administration session for which this request applies: (use a separate application form for each session) November 2009; deadline for application: September 30, 2009 January 2010; deadline for application: November 6, 2009 April 2010; deadline for application: March 3, 2010 June 2010; deadline for application: April 16, 2010 August 2010; deadline for application: July 16, 2010

3.

Examination(s) to be written (language of the exam and exam name/part): Exam Name/Part ELA 301 Pt. A ELA 301 Pt. B ELA 302 Pt. A ELA 302 Pt. B FLA 301 Pt. A FLA 301 Pt. B Franais 301 Pt. A Franais 301 Pt. B * E = English; F = French Exam Language and Exam Name/Part E* F* Social Studies 30 Pt. A Social Studies 30 Pt. B Social Studies 301 Pt. A Social Studies 301 Pt. B Social Studies 33 Pt. A Social Studies 33 Pt. B Social Studies 302 Pt. A Social Studies 302 Pt. B Exam Language and Exam Name E* F* Biology 30 Chemistry 30 (Old) Chemistry 30 (New) Physics 30 (Old) Physics 30 (New) Science 30 Pure Math 30 Applied Math 30

Student/Parent Declaration: S P I have read, understand, and agree to comply with the directives, rules, and procedures associated with the establishment and writing of a diploma examination at a Special Writing Centre. I understand that, if approved to establish a Special Writing Centre, the release of diploma examination marks is contingent upon the prepaid, timely, and secure return of all diploma examination materials related to that approval. The information on this form is accurate and complete. I understand that the personal information collected on this form pursuant to section 32(c) of the Freedom of Information and Protection of Privacy Act will be used to process and administer the writing and/or rewriting of the registered diploma examination(s) and/or for making the appropriate adjustment of marks in the registered subject(s). This information will be used for the purposes stated, by Alberta Education only

Signature of Student

Date

Signature of Parent or Guardian (if student is under 18 years of age)

Date

Page 1 of 2
Alberta Education September 2009

ALBERTA STUDENT NUMBER STUDENTS NAME

Principal Declaration (To be completed by the principal of the Alberta high school the student is currently attending): I have provided access to and explained to the student and his/her parent(s) all of the directives, rules, guidelines, and procedures associated with the handling and administration of diploma examinations at a Special Writing Centre. I am aware of the person and site that have been proposed as the Special Writing Centre Supervisor and Special Writing Centre site, respectively, and I support these proposals. I have reviewed this form and the Application to Supervise A Diploma Examination Special Writing Centre form that will be submitted by the student in support of a request to establish a Special Writing Centre and, to the best of my knowledge, the information on these forms is accurate and complete.

School Code Principals Name Fax Number ( )

School Name School Telephone ( School E-mail Address Date: )

Principals Signature

Submit forms by the specified deadline date to: Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

Alberta Education

Page 2 of 2

September 2009

ESL Application for Accommodations for Diploma Examinations 2009-2010

ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES
Year Month Day

BIRTH DATE (e.g., 90 Jul 20) PERMANENT ADDRESS

Apt/Street/Ave/P.O. Box/Route

SEX

MMale FFemale

TELEPHONE

Village/Town/City

Province

Postal Code

Educational Background of Student: Include country of origin, date of arrival in Canada [if applicable], language(s) spoken in the home, previous educational experience, language proficiency on arrival, etc.

The student has been utilizing extra time as an accommodation throughout his or her coursework and testing situations in the course(s) YES NO COURSE DEPENDENT that the student will be writing diploma examination(s): I attest that the above statement is true:
School staff signature, title, date

Language Proficiency Test Scores: Language Proficiency Test #1:

(Name and form used)

Date test was administered: Administrator (name and title): Test results and analysis: Section: Section: Section: Language Proficiency Test #2 [If applicable]: Raw Score: Raw Score: Raw Score:

Duration of assessment (hr/min):

Grade equivalency Grade equivalency Grade equivalency

(Name and form used)

Date test was administered: Administrator (name and title): Test results and analysis: Section: Section: Section: Raw Score: Raw Score: Raw Score:

Duration of assessment (hr/min):

Grade equivalency Grade equivalency Grade equivalency

Examination administration session for which this request applies (use a separate application form for each session): November 2009; deadline for application: September 30, 2009 June 2010; deadline for application: April 16, 2010 January 2010; deadline for application: November 6, 2009 August 2010; deadline for application: July 16, 2010 April 2010; deadline for application: March 3, 2010

Page 1 of 2
Alberta Education September 2009

ALBERTA STUDENT NUMBER STUDENTS NAME

Educator Observation and Recommendation Course name [Diploma exam being written]: The student has been receiving extra time in this course Educator's name and signature: Course name [Diploma exam being written]: The student has been receiving extra time in this course Educator's name and signature: Course name [Diploma exam being written]: The student has been receiving extra time in this course Educator's name and signature: Course name [Diploma exam being written]: The student has been receiving extra time in this course Educator's name and signature:

YES

NO

YES

NO

YES

NO

YES

NO

To be completed by the Alberta high school the student is attending:

Accommodations

English French Biology 30 Course #3 Extra Time

English French Course

English French Course

English French Course

English French Course

English French Course

School Code Principals Name

School Name School Telephone

Area Code

Principal/Designate Signature Second Contact Name and E-mail Address Name and school code of the writing centre where this student intends to write: Writing Centre Name To be completed by student and parent/guardian:

Date

School Code:

I/we understand that the personal information collected on this form pursuant to section 32(c) of the Freedom of Information and Protection of Privacy Act will be used to process and administer the writing and/or rewriting of the registered diploma examination(s) and/or for making the appropriate adjustment of marks in the registered Course(s). This information will be used only for the purposes stated by Alberta Education. I/we have accurately provided information on this application form.
Signature of Student Date

Signature of Parent/Guardian (if student is under 18 years of age)

Date

This form must be submitted to:

Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

This form must be fully completed to be processed by Alberta Education.

Page 2 of 2
Alberta Education September 2009

Request for Exemption from Writing Diploma Examinations

ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES
Year Month Day

For Learner Assessment Use Only Approved Signature SEX (e.g., 90 Jul 20)
Apt/Street/Ave/P.O. Box/Route MMale FFemale

Denied

BIRTH DATE PERMANENT ADDRESS

TELEPHONE

Village/Town/City

Province

Postal Code

E-mail ADDRESS

Exam administration session for which this request applies: November 2009 Reason for Request: Inclement Weather Administrative Error Bereavement [Death certificate/obituary attached] Relationship to Student: Other: (Specify) January 2010 April 2010 June 2010 August 2010

Acute Medical*

Court [Subpoena attached]

*Exemptions are not granted for ongoing or chronic medical conditions (see Chronic Medical Conditions in the Special Cases & Accommodations section of the General Information Bulletin). Note: If this request is for medical reasons, a doctor must complete Section C on this form or forward an official letter. The letter should be on the doctors letterhead or prescription pad and must include the doctors name and signature as well as the following information: date of medical visit specific medical reason for the student being unable to write the exam(s)

Section A Student and Parent/Guardian

I/we understand that the personal information collected on this form pursuant to section 32(c) of the Freedom of Information and Protection of Privacy Act will be used to process and administer the writing and/or rewriting of the registered diploma examination(s) and/or for making the appropriate adjustment of marks in the registered subject(s). This information will be used for the purposes stated, by Alberta Education only. I/we have accurately provided information on this request form. If this request relates to an acute medical condition, I/we authorize the release of personal medical information to support the application. I/we acknowledge that this request for exemption will be denied if I/we refuse to authorize the release of relevant personal medical information. Signature of Student Signature of Parent/Guardian (if student is under 18 years of age) Date Date Page 1 of 2
Alberta Education September 2009

Request for Exemption from Writing Grade 12 Diploma Examinations Continued

ALBERTA STUDENT NUMBER STUDENTS NAME

Section B - Principal
I recommend that
(Name of Student) (Date of Birth)

be granted a full exemption from writing the be granted a partial exemption from writing the Part(ie) A or B Reason for exemption and additional information from the school:

diploma examination(s) diploma examination(s)

Area Code

I attest the above application to be true. Principal/Designate Signature Principals Name School Code Fax Number
Area Code

Date: School Telephone

Area Code

School Name School E-mail Address

Second Contact Name and E-mail Address

Section C - Medical Doctor

I have confirmed that
(patients name)

has authorized the release of his/her medical information to

Alberta Education in support of a request for a diploma examination exemption I hereby certify that
(patients name)

is/was under my care and attention from

to

and in my opinion is/was unable to write his/her Alberta High School diploma examination(s) during

this period for the specific medical reason(s) indicated below:

Doctors Name (please print) Doctors Official Stamp Doctors Signature: Date: This form must be submitted to: Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977

Phone: (780) 674-5333 ext. 5255

Toll Free: 1-866-774-5333 Page 2 of 2

Alberta Education

September 2009

Diploma Examination Rescore Application Form 20092010

The personal information requested on this form will be used for the purposes stated by Alberta Education only.
ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES OTHER NAME(S) KNOWN BY
Year Month Day

Deadlines for receiving this form: November 2009 rescoreDecember 2, 2009 January 2010 rescoreMarch 5, 2010 April 2010 rescoreMay 14, 2010 June 2010 rescoreAugust 6, 2010 August 2010 rescoreSeptember 2, 2010

BIRTH DATE (e.g., 91 Jul 20) PERMANENT ADDRESS

Apt/Street/Ave/P.O. Box/Route

SEX

MMale FFemale

TELEPHONE

Village/Town/City

Province

Postal Code

Diploma Examinations Applied Mathematics 30 Biology 30 Chemistry 30 (Old) Chemistry 30 (New) ELA 301 ELA 302 Franais 301 French Language Arts 301 Physics 30 (Old) Physics 30 (New) Pure Mathematics 30 Science 30 Social Studies 30 Social Studies 33 Social Studies 301 Social Studies 302

Check the examination(s) you want rescored and the administration in which you wrote.

Nov

Jan

April

Jun

Aug

Important Learner Assessment must receive rescore requests no later than the deadline date specified on the Results Statement (see above) Rescore requests will be denied if the examinee fails to: submit payment sign the Student Declaration I am requesting the rescoring of
(number)

diploma

examination(s), at $26.25 (includes GST) each, for a total of $ .

Declaration: I acknowledge that a rescore mark will be the final mark for that particular examination whether the mark is raised, lowered, or remains the same.
Signature of Student (Required) Signature of Parent/Guardian (if student is under 18 yrs of age) Date

Method of Payment Cheque/Money Order (made payable to the Minister of Finance) Cash Debit Card Credit Card Do not send cash by mail or postdate cheques or money orders

Visa Master Card Cardholders name as printed on credit card (please print): Cardholders Signature: Card Number: Expiry Date:

Submit this form and the rescore fee(s) in person at or by fax, mail, or email to:
Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

Alberta Education

September 2009

Statement of Scribe, Reader, and/or Interpreter and Examination Supervisor: Diploma Examinations
I,
Scribe/Reader/Interpreter (please print)

and
Examination Supervisor (please print)

having read the procedures governing the use of a the diploma examination(s) in
Subject(s)

Scribe Reader certify that to the best of our abilities Interpreter

held at
School

during the
month

, 2010

examination period for

Students name (please print)

was administered and supervised in accordance with the specified procedures under the directives of the Minister of Education. was administered and supervised in accordance with the specified procedures under the directives of the Minister of Education, except as follows:

Dated this

day of

, 2010

Scribes/Readers/Interpreters Signature

Examination Supervisor Signature

School Code

Please sign and return with the Principals Statement. If more than one individual is providing accommodation services to one student, please fill out separate forms.

Alberta Education

September 2009

Accommodation Request Transfer Form 20092010

ALBERTA STUDENT NUMBER SURNAME LEGAL FIRST AND MIDDLE NAMES BIRTH DATE
Year Month Day

Special Cases Use Only Entered

SEX (e.g., 90 Jul 20)
Apt/Street/Ave/P.O. Box/Route MMale FFemale

TELEPHONE

PERMANENT ADDRESS

Village/Town/City

Province

Postal Code

E-mail ADDRESS

Note: This form should only be submitted when a student has transferred courses after an Application for Accommodations for Students with Special Diploma Examination Writing Needs form was submitted for the course in which he/she was originally registered. Submission of this form will ensure that the student receives the special format materials, which were requested earlier, for the correct diploma examination.
Session for which the accommodation(s) have been requested and the deadlines for submitting this form:

January 2010 Administration

Nov. 18, 2009

June 2010 Administration

April 27, 2010

August 2010 Administration

July 16, 2010

Student was originally registered in [please check ]: Social Studies 30 Social Studies 33 Social Studies 30-1 Social Studies 30-2 Applied Mathematics 30 Pure Mathematics 30 English Language Arts 30-1 English Language Arts 30-2 Other (Specify):

Student has transferred to [please check ]: Social Studies 30 Social Studies 33 Social Studies 30-1 Social Studies 30-2 Applied Mathematics 30 Pure Mathematics 30 English Language Arts 30-1 English Language Arts 30-2 Other (Specify):

The following material(s) were requested in the original accommodation application submission [please check CD for students with visual impairment [Accommodation 1] CD for students with learning or physical disability [Accommodation 2] Large Print Braille Coloured Paper Other, Specify:

]:

School Name: Writing Centre Name: Students Signature Principals Signature

School Code: School Code:

Date:

This form must be submitted by the specified deadline dates to: Alberta Distance Learning Centre Box 4000 Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255

Toll Free: 1-866-774-5333

Alberta Education

September 2009