Jana Academy Student Registration Form
Kindly complete this form to register your child. All information will be kept confidential.
School Year I'm registering for:
*
January 26/27
September 26/27
January 27/28
Grade at the Start of the School Year:
*
Pre-school
Junior Kindergarten
Senior Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Previous School (If Applicable)
Student's Name ( Enter as written on health card)
*
Full Name
Parent's/Gradian's Name
*
Full Name
Second Parent's/Gradian's Name
*
Full Name
Student's Date of Birth
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Emergency Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Health Issues Allergies
*
Student's Health Card
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Student's Immunization Record
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Payment
1) The Signatory accepts that School Fees are payable monthly via preauthorized order: (JK/SK/Preschool) $550/month for 10 months and (Grade 1, Grade 2, Grade 3, Grade 4, Grade 4) $650/month for 10 months. 2) To confirm the student's enrollment, the signatory agrees to pay a non-refundable full fee for the first month and a one time application fee, of $150. Payment should be made via e-transfer to JanaAcademyCanada@gmail.com.
Terms and Conditions
Jana Academy is not responsible for any loss or damage to the student's personal belongings. I further release, remise, and discharge Jana Academy, its administrators, board members, teachers and their respective heirs, executors, successors, and assigns, of and from all claims, demands, damages, actions or causes of action arising or to arise by reason of the child's participation in the school, activities, trips and programs of Jana Academy. Withdrawal policy: Two months’ tuition is required if a student leaves mid-semester. Minimum 30 Days Notice is required to leave the school for regular school students.
Signatory's Name
*
Full Name
Submit
Should be Empty: