Socrates Registration Form

Student Registration Form

For the 2021-22 School Year
Our school runs Saturdays 12:30pm - 2:30pm and is located at:

Applewood Heights Secondary School
945 Bloor St East
Mississauga ON
Full Name of Student

First NameLast Name
Greek School Grade
Age of Student
Name of English Local Day School
Father's Name

First NameLast Name
Mother's Name

First NameLast Name
Home Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Phone
Please enter a valid phone number.
Business Phone
Please enter a valid phone number.
Email
example@example.com
Phone number to use in an Emergency
Please enter a valid phone number.
Please state any pertinent information regarding your child that his/her teacher should be aware of (medical/health, learning style etc)
Fee per Child: 1^st & 2^nd Child - $250 3^rd Child - $200 4^th Child - Free
Number of Children
Total Fee(s)
Please do not send payment at this time, we will be in contact once we have confirmed our program is able to run this year.
Should be Empty:

Student Registration Form