Student Registration System

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School Year Applying For

School Year

Please select for which school year you wish for your child to start.

STUDENT ADMISSION INFORMATION

Date of Birth

You must provide an original birth certificate as proof of age.

Gender

Legal Name:

First Name

Middle Name

Last Name

Usual Name:

First

Middle

Last

Home Address:

Apartment

House Number (e.g. 12345)

Street Name (e.g. Granville, No. 3, etc)

Street Type

City

Province

Postal Code

Student Contact Information

Home Phone Number

Alternate Phone

Student Cell Phone

Student Email

Please provide the student's email address, if applicable (One email address).

Previous Student Information

Previous Country or Province of study

Please provide the most recent country or province

Previous School and City

Is the student currently attending another school or has been withdrawn? If so, please enter the school name and city here.

Years of Schooling in Canada

Please provide the year(s) that the student has studied in Canada.

School Status

Is the student enrolled at the above school?

Withdrawal Date

Please enter the student's withdrawn date, if applicable.

Additional Resource Support

Has your child received additional support in the past? Please provide any applicable reports or documentation.

Details

If you entered "academic", "behavioural", "physical", or "other" to requiring additional support, please provide us with the details. You will need to bring any required documents, eg. doctor's reports with you at your scheduled appointment time.

Student Citizenship Status / Immigration

Citizenship

Country Of Birth

Country of Citizenship

Language(s) Spoken at Home

Language Most Used

Home Language

Additional Language

Aboriginal Ancestry

Band Info

Medical Information

Personal Health No.

Any Medical Conditions?

Details

If there are allergies or medical conditions, please provide the details.

Medication Type(s) with Dosage(s)

Parents / Legal Guardians

Currently lives with BOTH parents/legal guardians

YesNo

First Parent / Legal Guardian

1st Relationship

Please provide the relationship that the 1st parent / legal guardian is with the student.

1st Citizenship

Please provide the citizenship status for the 1st parent / legal guardian.

Expiration Date of Permit

Please provide the expiration date of the Study or Work Permit for the 1st parent / legal guardian.

First Name

Last Name

1st Employer

Please provide the 1st parent / legal guardian's employer's company name.

1st Cell

Please provide the 1st parent / legal guardian's cell phone no.

1st Work

Please provide the 1st parent / legal guardian's work phone no.

1st Email

Please provide the 1st parent / legal guardian's email address.

1st Home Address

Apartment

House Number

Street Name

Street Type

City

Province

Postal Code

Second Parent / Legal Guardian (IF APPLICABLE)

2nd Relationship

Please provide the relationship that the 2nd parent / legal guardian is with the student

2nd Citizenship

Please provide the citizenship status for the 2nd parent / legal guardian.

Expiration Date of Permit

Please provide the expiration date of the Study or Work Permit for the 2nd parent / legal guardian.

First Name

Last Name

2nd Employer

Please provide the 2nd parent / legal guardian's employer's company name.

2nd Cell

Please provide the 2nd parent / legal guardian's cell phone no.

2nd Work

Please provide the 2nd parent / legal guardian's work phone no.

2nd Email

Please provide the 2nd parent / legal guardian's email address.

2nd Home Address

Apartment

House Number

Street Name

Street Type

City

Province

Postal Code

Country

Emergency Contact Information

1st Contact Information

1st Contact Relationship

Please provide the relationship that the 1st emergency contact is with the student.

1st Name

First Name

Last Name

1st Contact Home

Please provide the home phone no. for the 1st emergency contact.

1st Contact Cell

Please provide the cell phone no. for the 1st emergency contact.

1st Contact Work

Please provide the work phone no. for the 1st emergency contact.

2nd Contact Information

2nd Contact Relationship

Please provide the relationship that the 2nd emergency contact is with the student.

First Name

Last Name

2nd Contact Home

Please provide the home phone no. for the 2nd emergency contact.

2nd Contact Cell

Please provide the cell phone no. for the 2nd emergency contact.

2nd Contact Work

Please provide the work phone no. for the 2nd emergency contact.

Emergency Contact - Medical Information

Doctor's Name

Doctor's Phone

Dentist's Name

Dentist's Phone

Sibling Information

1st Sibling's Name

First Name

Last Name

1st Sibling School

Provide the name of the siblings current Richmond school.

1st Sibling Grade

Provide the current grade of the sibling.

2nd Sibling's Name

First Name

Last Name

2nd Sibling School

Provide the name of the siblings current Richmond school.

2nd Sibling Grade

Provide the current grade of the sibling.

Notes

If you have more than two siblings and/or any additional information, please provide information here. (Maximum of 200 characters)

UPLOAD DOCUMENTS

Document

Declaration and Signature

Date

By submitting this form, I declare the above information is true and correct in every respect. I understand that providing false information would constitute sufficient grounds to reassess the application and may lead to my child being withdrawn, in which case I would be responsible for my child's educational costs. My child and I will be living at the residence stated in this application and I understand that at least one parent / legal guardian must remain ordinarily resident in British Columbia.

First Name

Last Name

Relationship