Admissions
Applicant Information
Student Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Date of Birth
-
Month
-
Day
Year
Date
Place of Birth
Gender
Male
Female
Grade Applying For
Household Information
Parent/Guardian Name #1
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Occupation
Parent/Guardian Name #2
First Name
Last Name
Same address as parent #1
If not, complete below
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Occupation
Name and Age of Siblings
Tell us more about your family
First Name
Last Name
Age
First Name
Last Name
Age
First Name
Last Name
Age
First Name
Last Name
Age
Financial Responsibility & Notices
Who is financially responsible?
Student Information
How is the student's general health?
If the student has any allergies, please list them down below:
What are their special interests?
How much time screen time do they spend? (Television, video games, computer, smart phone etc.)
Do they participate in any private lessons or sports activities? (List details below)
Please describe their educational experience up until now.
How would you describe their social/emotional development?
Have you ever sought counselling or a professional evaluation for your child?
Yes
No
Is there anything else we should know about their development and needs?
Expectations
Why would you like your child to attend Saugeen Academy?
What do you hope to receive from our program for your child and family?
Parent/Guardian Signature
Date Signed
-
Month
-
Day
Year
Date
Parent/Guardian Signature
Date Signed
-
Month
-
Day
Year
Date
Admissions Checklist
Have you included the following items in your application?
Completed and signed application form
IEP documentation (if applicable)
$200 application fee (payable by e-transfer to
elisa@saugeenacademy.org
or cheque to Saugeen Academy)
I will pay later
Submit
Should be Empty: