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PROVINCIAL

DIPLOMAEXAMINATION

PROCEDURES

FOR

DISTANCE LEARNINGSTUDENTS

2009-2010

AlbertaDistance Learning Centre


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Revised November 4, 2009 - SUBJECT TO CHANGE - http://education.alberta.ca/admin/testing/diplomaexams.aspx

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 confirm

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.

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


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2009-2010ALBERTA DISTANCE LEARNING CENTREDIPLOMA EXAMINATION PROCEDURES

FOR SENIOR HIGH STUDENTSPrint 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. Thentake 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 floor) 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 confirm 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 inthis schedule. Adjustments may not be made to examination starting times. All Part (ie) B examinations

are secured.

NOVEMBER 2009

[ADLC offices only] (Registration deadline is September 30, 2009)

Tuesday, November 3 9:00 to 11:30 a.m. English Language Arts 30-2 Part A

1:00 to 3:30 p.m. English Language Arts 30-2 Part B

Wednesday, November 4 1:00 to 3:00 p.m. Pure Mathematics 30

Thursday, November 5 1:00 to 3:00 p.m. Chemistry 30 (New Program Only)

Friday, November 6 1:00 to 3:00 p.m. Physics 30 (New Program Only)

JANUARY 2010 (Dates Revised November 2009) (Registration deadline is November 2, 2009)Thursday, January 14 9:00 to 11:30 a.m. English Language Arts 30-1 Part A

English Language Arts 30-2 Part A

Friday, January 15 9:00 to 11:00 a.m. Social Studies 30 Part(ie) A

9:00 to 11:30 a.m. Social Studies 30-1 Part(ie) A

9:00 to 11:00 a.m. Social Studies 33 Part(ie) A


Monday, January 18 9:00 to 11:30 a.m. Franais 30-1 Partie A

French Language Arts 30-1 Part A

Thursday, January 21 9:00 to 10:00 am. Chemistry 30 (Old Program) Part(ie) A

9:00 to 11:00 am. Chemistry 30 (New Program)

1:00 to 3:00 pm. Chemistry 30 (Old Program) Part(ie) B

Friday, January 22 9:00 to 11:00 a.m. Applied Mathematics 30

Pure Mathematics 30

Monday, January 25 9:00 to 11:00 a.m. Franais 30-1 Partie B

9:00 to 11:30 a.m. French Language Arts 30-1 Part B

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

Tuesday, January 26 9:00 to 11:30 a.m. English Language Arts 30-1 Part B

English Language Arts 30-2 Part B

Wednesday, January 27 9:00 to 11:00 a.m. Social Studies 30 Part(ie) B

Social Studies 30-1 Part(ie) B

Social Studies 33 Part(ie) BSocial Studies 30-2 Part(ie) B

Thursday, January 28 9:00 to 10:00 a.m. Physics 30 (Old Program) Part(ie) A

9:00 to 11:00 a.m. Physics 30 ((New Program)

1:00 to 3:00 p.m. Physics 30 (Old Program) Part(ie) B

Science 30

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

ISED

ATES


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2009- 2010 School Year (continued)

The grade 12 diploma examinations must be administered according to the dates and times indicated inthis schedule. Adjustments may not be made to examination starting times. All Part (ie) B examinations

are secured.

APRIL 2010 [ADLC offices only] (Registration deadline is March 4, 2010) Monday, April 12 9:00 to 11:30 a.m. English Language Arts 30-1 Part A


Tuesday, April 13 9:00 to 11:30 a.m. Social Studies 30-1 Part(ie) A


Social Studies 30-2 Part(ie) A

Social Studies 33 Part(ie) A

1:00 to 3:00 p.m. Social Studies 30-1 Part(ie) B

Social Studies 30 Part(ie) B



Wednesday, April 14 9:00 to 11:00 a.m. Biology 30

JUNE 2010 (Dates Revised November 2009) (Registration deadline is April 14, 2010)Monday, June 14 9:00 to 11:30 a.m. English Language Arts 30-1 Part A


Tuesday, June 15 9:00 to 11:00 a.m. Social Studies 30 Part(ie) A



9:00 to 11:00 a.m Social Studies 30-2 Part(ie) A

Wednesday, June 16 9:00 to 11:30 a.m. Franais 30-1 Partie A


Thursday, June 17 9:00 to 10:00 a.m. Chemistry 30 (Old Program) Part(ie) A

9:00 to 11:00 am. Chemistry 30 (New Program)

1:00 to 3:00 p.m. Chemistry 30 (Old Program) Part(ie) B

Friday, June 18 9:00 to 11:00 am. Applied Mathematics 30

Pure Mathematics 30

Tuesday, June 22 9:00 to 11:00 a.m. Franais 30-1 Partie B

9:00 to 11:30 a.m. French Language Arts 30-1 Part B

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

Wednesday, June 23 9:00 to 11:30 a.m. English Language Arts 30-1 Part B


Thursday, June 24 9:00 to 11:00 a.m. Social Studies 30 Part(ie) B




Friday, June 25 9:00 to 10:00 a.m. Physics 30 (Old Program) Part(ie) A

9:00 to 11:00 a.m. Physics 30 (New Program)


Science 30

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

ISED

ATES


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2009-2010 School Year (continued)

The grade 12 diploma examinations must be administered according to the dates and times indicatedin 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.

Wednesday, August 4 9:00 to 11:30 a.m. English Language Arts 30-1 Part A




Thursday, August 5 9:00 to 11:00 a.m. Social Studies 30 Part(ie) A




1:00 to 3:00 p.m. Social Studies 30 Part(ie) BSocial Studies 30-1 Part(ie) B



Friday, August 6 9:00 to 11:00 a.m. Applied Mathematics 30

Pure Mathematics 30

9:00 to 10:00 a.m. Chemistry 30 (Old Program) Part(ie) A

1:00 to 3:00 p.m. Chemistry 30 (Old Program) Part(ie) B

Chemistry 30 (New Program)

Monday, August 9 9:00 to 11:00 a.m. Biology 30

Tuesday, August 10 9:00 to 10:00 a.m. Physics 30 (Old Program) Part(ie) A9:00 to 11:00 a.m. Physics 30 (New Program)


Science 30

Wednesday, August 11 9:00 to 11:30 a.m. Franais 30-1 Partie A


1:00 to 3:00 p.m. Franais 30-1 Partie B

1:00 to 3:30 p.m. French Lanuage Arts 30-1 Part B

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 orone 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 computersavailable for ADLC students to complete their diploma examinations at our writing centres at SAIT in

Calgary and at our Lethbridge office. To book a computer at SAIT, please contact our Calgary office.

To book a computer in Lethbridge, please contact the Lethbridge office.

ADLC Writing Centres (November, January, April, and June)

Barrhead - ADLC Main Office (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 floor (10044 - 108 St.)

Edmonton- November, April, and August................................................................ [School Code - 1223]Financial Building, 8th floor (10621-100 Ave.)

Lethbridge -November and April............................................................................. [School Code - 0099]

ADLC Regional Office

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 Educationat 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 Writing Centres - August 2010

2601 Athabasca Edwin Parr Composite Community School

2316 Barrhead Vista Outreach, 4923 - 50 Avenue

2950 Bonnyville Bonnyville Centralized High School

6718 Brooks Brooks Composite High School

9996 Calgary SAIT (Location to be announced at a later date)

4504 Camrose PACE Outreach School

5725 Drumheller Drumheller Composite High School

1223 Edmonton Financial Building, 10621 - 100 Avenue (8th Floor)

1857 Fort McMurray Fort McMurray Composite High School

1141 Grande Prairie Grande Prairie Composite High School

1715 High Level High Level Learning Store

2011 Hinton Harry Collinge High School

2702 Lac La Biche J.A. Williams High School

6466 Lethbridge Winston Churchill High School

6850 Medicine Hat Medicine Hat High School

1511 Peace River Peace River High School

4444 Red Deer Lindsay Thurber Composite High School

3610 Vegreville Vegreville Composite High School

3909 Wainwright Wainwright High School

3144 Wetaskiwin 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 identification 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 writeprior 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 confirm 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 LearnerAssessment Branch, is available to administer the examination. The supervising examiner could

be, for example, a school principal, a teacher, a police officer, or a commissioned military officer.

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 theApplication 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

completedDiploma 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 anexamination at a special writing centre, and to return the examination to the Learner AssessmentBranch by courier.

Please access Alberta Education's website at

http://education.alberta.ca/admin/testing/diplomaexams.aspx to confirm 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 theinformation in these bulletins.

General Information Bulletin

This bulletin contains information on

examination schedules and significant 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 containsinformation 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 EducationInformation 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 floor, 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. Official 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 official

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 accommodationrequested 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.

ADLCWebsite Updates: The Registration Guide and all other information are updated regularly on theADLC 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 final 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 final

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 final 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


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Alberta Education September 2009

Diploma Examination Registration Form20092010Note: If you are rewriting the examination(s) for which you are registering, you must also submit aDiploma 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 STUDENTNUMBER

SURNAME

LEGAL FIRST ANDMIDDLE NAMES

OTHER NAME(S)KNOWN BY

BIRTH DATE

Year Month Day

SEXMMaleFFemale TELEPHONE

(e.g., 91 Jul 20)

PERMANENTADDRESS

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

Village/Town/City

Province Postal Code

Diploma Examination(s) To Be Written Administration Session

English French January 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 30Science 30

Social Studies 30

Social Studies 33

Social Studies 301

Social Studies 302Notes: 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 adiploma examination you must complete theApplication 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 Code:

Writing Centre Principals Signature (if applicable)

FOR OFFICEUSE ONLY

Diploma examination registration deadline, by session:January 2010 session: November 2, 2009 June 2010 session: April 14, 2010 August 2010 session: July 5, 2010

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

JJ

(January, June and August)


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April2010Diploma Examination Registration Form20092010

Note: If you are rewriting the examination(s) for which you are registering, you must also submit aDiploma ExaminationRewrite Fee Form and the rewrite fee.

The personal information collected on this form will be used by Alberta Education for examination registration purposes only.


SURNAME



BIRTH DATE

Year Month Day


(e.g., 91 Jul 20)

PERMANENTADDRESS


Village/Town/City


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 inadvance 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 theApplication 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 Code:

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



Box 4000Barrhead AB T7N 1P4



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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 yourschool, you must submit aDiploma Examination Registration Form to register for the examination(s) you intend to rewrite.

The personal informat llected on this form will be used by Alberta Education for rewrite fee payment purposes only.ion co



SURNAME


BIRTH DATE

Year Month Day


(e.gApt/Street/A

., 91 Jul 20)

PERMANENTADDRESS

ve/P.O. Box/Route

Village/Town/City


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

Applied Mathematics 30 English Language Arts 301 Physics 30 (Old) Social Studies 30Biology 30 English Language Arts 302 Physics 30 (New) Social Studies 33Chemistry 30 (Old) Franais 301 Pure Mathematics 30 Social Studies 301Chemistry 30 (New) French Lan rts 301 Science 30 Social St 02guage A udies 3

I am submitting payment for the rewriting of diploma examination(s) at $26.25 each, for a total of: $

Method of PaymentCheque/Money Order (made payable Visa Master Card

to the Minister of Finance) lders name as printed on credit card (please print):CardhoCash Debit CardCredit Card

Cardholders S re:ignatuDo not send cash by mail or postdatecheques or money orders Card Number :

Expiry Date:

Submit this form and the rewrite fee(s) in person at or by fax or mail to:

Alberta Distance Learning CentreBox 4000Barrhead AB T7N 1P4


Notes: Rewrite fees are only requiredto 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 outstandingdebt. 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 $10.50processing fee will be charged for each examination that is not written. Only the remaining rewrite fee monies will be refundedupon request.


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SpecialDiploma Exam

Forms


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Application for Accommodations for Students

with Special Diploma Examination

Writing Needs 20092010 For Learner Assessment Use OnlyApproved Denied

SignatureALBERTA STUDENTNUMBER

SURNAME


BIRTH DATE

Year Month Day


(e.g., 91 Jul 20)

PERMANENTADDRESS


Village/Town/City


E-MAIL ADDRESS

This student is currently registered with Alberta Education with a Special Education Student Code: Yes No

If yes, indicate coding

If the student does not have a Special Education Student Code, the results of a formal assessment completed by a qualifiedprofessional must be submitted. If the section below is completed and the results of a formal assessment are submitted, there isno 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 deadlinedate and forward assessment and/or supplementary information as soon as it becomes available.

Note: Please use theESL Application for Accommodations for Diploma Examinationsform when applying for an extra timeaccommodation for ESL and Francisation students (see Special Cases & Accommodations andExamination AdministrationForms sections of the General Information Bulletin).

If the student is registered at Alberta Education with a Special Education Student Code, please check which accommodations arecurrently included in the students IPP and being provided and used:

No. 1 CD for Visually Impaired Students No. 7 Braille

No. 2 CD for Students with Learning or Physical Disability No. 8 Reader

No. 3 Extra Time No. 9 Sign Language Interpreter

No. 4 Not currently assigned No. 10 Taped Response

No. 5 Scribe No. 11 Franklin Language Master

No. 6 Large print (20-point font) No. 16 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 June 2010; deadline for application: April 16, 2010January 2010; deadline for application: November 6, 2009 August 2010; deadline for application: July 16, 2010April 2010; deadline for application: March 3, 2010

Page 1 of 2


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Application for Accommodations for Students with Special Diploma

Examination Writing NeedsContinued


STUDENTS NAME

Indicate the course(s) and accommodation(s) requested by referencing the list of accommodations on page 1 of thisapplication. 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

Course

English French

Course

English French

Course

English French

Course

English French

Course

Note: Please specify the specific course name of the examination for which you are requesting accommodation(s) e.g., English LanguageArts 301; Chemistry 30 (New). If requesting different accommodations for the part(ie) A and part(ie) B sections of a Humanitiesexamination, 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 School Name

Principals Name School TelephoneArea Code

School E-mail Address Fax NumberArea Code

Principal/Designate Signature Date

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

Informationand Protection of Privacy Actwill be used to process and administer the writing and/or rewriting of theregistered 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

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.



Box 4000


Fax: (780) 674-6977

Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

Page 2 of 2
mailto:[email protected]


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Application to Establish a Diploma Examination

Special Writing Centre 20092010


BIRTHDATE

(e.g. 90 Jul 20

Year Month Day

SEXM/F

TELEPHONE

SURNAME


E-mail ADDRESS

For Office Use Only

Approved Denied

_______________________

Signature

Note: For this form to be processed, a completedApplication to Supervise a Diploma Examination Special Writing Centre form must also besubmitted.

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 June 2010; deadline for application: April 16, 2010January 2010; deadline for application: November 6, 2009 August 2010; deadline for application: July 16, 2010April 2010; deadline for application: March 3, 2010

3. Examination(s) to be written(language of the exam and exam name/part):Exam Name/Part Exam Language and Exam Name/Part Exam Language and Exam Name

E* F* E* F*

ELA 301 Pt. A

ELA 301 Pt. B

ELA 302 Pt. A

ELA 302 Pt. BFLA 301 Pt. A

FLA 301 Pt. B

Franais 301 Pt. A

Franais 301 Pt. B

Social Studies 30 Pt. A

Social Studies 30 Pt. B


Social Studies 301 Pt. BSocial Studies 33 Pt. A




Biology 30

Chemistry 30 (Old)

Chemistry 30 (New)

Physics 30 (Old)Physics 30 (New)

Science 30

Pure Math 30

Applied Math 30

* E = English; F = French

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 adiploma 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 theprepaid, 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 Informationand Protection ofPrivacy Actwill be used to process and administer the writing and/or rewriting of the registered diploma examination(s) and/or for makingthe appropriate adjustment of marks in the registered subject(s). This information will be used for the purposes stated, by AlbertaEducation only

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

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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 theApplication to Supervise A Diploma Examination Special Writing Centre form that will be submitted bythe student in support of a request to establish a Special Writing Centre and, to the best of my knowledge, the information on these formsis accurate and complete.


Principals Name School Telephone ( )

Fax Number ( ) School E-mail Address

Principals Signature Date:

Submit forms by the specified deadline date to:


Box 4000


Fax: (780) 674-6977

Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

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ESL Application for Accommodations for Diploma

Examinations 2009-2010ALBERTA STUDENT

NUMBER

SURNAME

LEGAL FIRST AND

MIDDLE NAMES

BIRTH DATE

Year Month Day


(e.g., 90 Jul 20)

PERMANENT

ADDRESS


Village/Town/City


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)

that the student will be writing diploma examination(s): YES NO COURSE DEPENDENT

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: Duration of assessment (hr/min):

Administrator (name and title):

Test results and analysis:

Section:

Section:

Section:

Raw Score:

Raw Score:

Raw Score:

Grade equivalency

Grade equivalency

Grade equivalency

Language Proficiency Test #2 [If applicable]:(Name and form used)

Date test was administered: Duration of assessment (hr/min):

Administrator (name and title):

Test results and analysis:

Section:

Section:

Section:

Raw Score:

Raw Score:

Raw Score:

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

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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 YES NO

Educator's name and signature:










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



Principal/Designate Signature Date

Second Contact Name and E-mail AddressName and school code of the writing centre where this student intends to write:

Writing Centre Name School Code:

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 Informationand

Protection of Privacy Actwill 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.





Box 4000



This form must be fully completed to be processed by Alberta Education.Page 2 of 2


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Request for Exemption from Writing Diploma

ExaminationsALBERTA STUDENTNUMBER For Learner Assessment Use

Only

Approved Denied

Signature

SURNAME


BIRTH DATEYear Month Day SEX MMaleFFemale TELEPHONE

(e.g., 90 Jul 20)

PERMANENTADDRESS


Village/Town/City


E-mail ADDRESS

Exam administration session for which this request applies:

November 2009 January 2010 April 2010 June 2010 August 2010

Reason for Request:

Inclement Weather Administrative Error Bereavement [Death certificate/obituary attached]Relationship to Student:

Acute Medical* Court Other: (Specify)[Subpoena attached]

*Exemptions are not granted for ongoing or chronic medical conditions (see Chronic Medical Conditions in the SpecialCases & 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. Theletter should be on the doctors letterhead or prescription pad and must include the doctors name and signature aswell 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 ofInformationand Protection of Privacy Actwill be used to process and administer the writing and/or rewriting of theregistered 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 tosupport the application. I/we acknowledge that this request for exemption will be denied if I/we refuse to authorize therelease of relevant personal medical information.



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Request for Exemption from Writing Grade 12

Diploma Examinations Continued


STUDENTS NAME

Section B - Principal

I recommend that (Name of Student) (Date of Birth)

be granted a full exemption from writing the diploma examination(s)

be granted a partial exemption from writing the Part(ie) A or B diploma examination(s)

Reason for exemption and additional information from the school:

Area Code

I attest the above application to be true.

Principal/Designate Signature Date:



Fax Number School E-mail AddressArea Code

Second Contact Name and E-mail Address

Section C - Medical Doctor

I have confirmed that has authorized the release of his/her medical information to(patients name)

Alberta Education in support of a request for a diploma examination exemption

I hereby certify that is/was under my care and attention from(patients name)

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:



Box 4000

Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333

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Diploma Examination Rescore Application Form20092010

The personal information requested on this form will be used for the purposes stated by Alberta Education only.

Deadlines for receiving this form:November 2009 rescoreDecember 2, 2009January 2010 rescoreMarch 5, 2010April 2010 rescoreMay 14, 2010

June 2010 rescoreAugust 6, 2010August 2010 rescoreSeptember 2, 2010


SURNAME



BIRTH DATE

Year Month Day


(e.g., 91 Jul 20)

PERMANENTADDRESS


Village/Town/City


Diploma Examinations

Check the examination(s) you want rescored and

the administration in which you wrote.

Important

Learner Assessment must receive rescore requests nolater than the deadline date specified on theResultsStatement (see above)Rescore requests will be denied if the examinee fails to: submit payment sign the Student Declaration

I am requesting the rescoring of diploma(number)

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

total of $ .

Declaration: I acknowledge that a rescore mark will bethe final mark for that particular examination whetherthe 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

Nov Jan April Jun Aug

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 30Social Studies 30

Social Studies 33

Social Studies 301

Social Studies 302

Method of Payment

Cheque/Money Order (made payable


Visa Master Cardto the Minister of Finance) lders name as printed on credit card (please print):Cardho

Cash Debit CardCredit Card

Cardholders S re:ignatu

Do not send cash by mail or postdatecheques or money orders 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 CentreBox 4000Barrhead, AB T7N 1P4Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333


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Statement of Scribe, Reader, and/or Interpreter and

Examination Supervisor: Diploma Examinations

I, andScribe/Reader/Interpreter (please print) Examination Supervisor (please print)

Scribe

having read the procedures governing the use of a Reader certify that to the best of our abilities

Interpreterthe diploma examination(s) in

Subject(s)

held at during the , 2010School month

examination period forStudents name (please print)

was administered and supervised in accordance with the specified procedures under thedirectives of the Minister of Education.

was administered and supervised in accordance with the specified procedures under thedirectives 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.


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Accommodation Request Transfer Form 20092010


SURNAME


Special Cases Use Only

Entered

BIRTH DATE Year Month Day

SEX MMaleFFemale TELEPHONE

(e.g., 90 Jul 20)

PERMANENTADDRESS


Village/Town/City


E-mail ADDRESS

Note: This form should only be submitted when a student has transferred courses after anApplication for Accommodationsfor Students with Special Diploma Examination Writing Needsform was submitted for the course in which he/she wasoriginally registered. Submission of this form will ensure that the student receives the special format materials, whichwere 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 AdministrationNov. 18, 2009

June 2010 AdministrationApril 27, 2010

August 2010 AdministrationJuly 16, 2010

Student was originally registered in [please check5 ]:

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 check5 ]:

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 check5]:

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: School Code: Date:

Writing Centre Name: School Code:

Students Signature

Principals Signature

This form must be submitted by the specified deadline dates to:


Box 4000

Barrhead, AB T7N 1P4 Fax: (780) 674-6977 Phone: (780) 674-5333 ext. 5255 Toll Free: 1-866-774-5333


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