NCCS NEW ENROLLMENT

1. Student Details

Student Name*

Legal First Middle Legal Last

*

Preferred First Name Preferred Last Name

2. Please Provide Student's PEN (if known)

Student PEN (Personal Education Number)

3. Additional Student Information

Student Email Address

Student Phone Number

Date Of Birth*

Gender*

Citizenship*

4. Student's Previous School

*

School Name Town/City Province Phone

5. Student History

Comment on your child's academic progress

Has your child ever been assessed for and/or diagnosed with a condition that results in learning disabilities?*

Yes
No

Has your child ever been involved in unlawful and/or violent behavior?*

Yes
No

6. Emergency Contact Person (other than parent)

*

Name Email Address Phone Relationship to student

7. Medical Information

BC Medical Number*

I don't have a BC Medical Number

Have you recently applied for a BC medical number?*

Yes
No

Provide medical number for previous province*

Are there any allergies or medical concerns?

Provide family doctor's information

Family Doctor's name Family Doctor's phone/email

8. Enrollment Year & Grade

Please select the school year and grade that you are enrolling the student in.

School Year*

Grade*

9. Parental Permission

I permit my child to go on walking field trips around the school and to local facilities (within 2 km).*

Yes
No

I permit my home phone number, mailing address, child's name and grade to be shared with parents of NCCS.*

Yes
No

I permit my child's name and photo to be used in school publications (ie. school newsletters), both electronic and paper.*

Yes
No

I permit my child's photo to be used in any school publication.*

Yes
No

I permit my child to be included in any media coverage of a school event.*

Yes
No

The following individuals have my permission to pick up my child(ren).

10. Agreement

I/We are willing to support the school, the decisions of the Principal and the regulations passed by the school board.*

Yes
No

Please type your full legal name to the above statement. Typed names suffice as handwritten signatures.

NCCS Enrollment Form

Welcome!

1. Parent/Guardian Details

2. Is The Student Currently Living With Both Parents?

3. Provide Details Of Second Parent

4. What Is Your Citizenship Status In Canada?

5. Are You Currently A Resident Of British Columbia?

6. Provide Your Home Address

7. Provide Your Mailing Address

8. How Did You Hear About Us? (optional)

9. Which Church Do You Attend? (optional)

10. Society Membership

11. Tuition