Student Information

First Name *

Last Name *

E-mail *

Telephone *

Applying for Grade *

School Year *

Birthdate *

Place of Birth *

Street Address *

City *

Postal code *

Citizenship *

Canadian

Landed Immigrant

Parent/Guardian Information

Parent/Guardian #1

Full Name *

Occupation *

Telephone *

E-mail *

Full Address

Parent/Guardian #2

Full Name

Occupation

Telehone

E-mail

Full Address

Additional Information

If parents are separated or divorced, please indicate with whom the child lives

Address to which statement of fees, reports and correspondence are to be sent *

Is there a legal reason both parents cannot be included in the admission process? *

Yes

If yes, please explain

Languages Spoken at Home *

Names and ages of siblings (or step-siblings)

Emergency Contact

Full Name *

Relationship *

Telephone *

School History

School Presently Attending

School Name *

School Address *

Years Attended *

Present Grade *

Please list previous schools attended and dates.

List any grade(s) the student has repeated

Describe any educational assistance the student is receiving or has received in the past

List any educational, psychological or medical assessments including dates

Please upload copies of most recent school report, last year’s final report and assessments with this application.

Medical History

Physician *

Physician Phone Number *

Please list any serious allergies or medical conditions and/or medication the student takes regularly

Is there any other medical information of which the school should be aware? *

Additional Information

Extra-Curricular Activities: List any hobbies, recreational or other activities, including clubs the student belongs to *

List any additional information that would best describe the student

Signatures

Signature of Parent/Guardian #1 *

Clear

Signature of Parent/Guardian #2 *

Clear

Signature Date *