JSKK School Application Form

"I challenge the darkness if nothing else, then at least around myself, I will not let it settle"

- Jaswant Singh Khalra
School Application Form
Campus
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Place of Birth
Gender
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Grade Level
School Year
School Last Attended
Bus services requirement:
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Legal Custodian Information
Parent/Custodian's Name - Primary

First NameLast Name
Occupation
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Custodian's name - Secondary

First NameLast Name
Occupation
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Person

First NameLast Name
Emergency Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
File Upload
Please provide the following documents:

1) Birth Certificate
2) Proof of Guardianship
3) Proof of Residency
4) Record of Immunizations
5) Proof of Payment (Link below)

At the following e-mail address:
info@jaswantsinghkhalrakhalsaschool.com
Health History
If the student have any allergies, please list them down below:
Does the student have any medical conditions that you would like to declare?
PHOTO & MEDIA CONSENT:
I permit photos, videos, and audio recordings of my child to be used for promotional and educational purposes, including social media.

MEDICAL CONSENT:
I confirm all medical information is provided and authorize staff to give first aid and seek emergency treatment if needed.
Registration Fee:

prevnext( X )
CADOne time application Fee *non-refundable*
Date Signed

MonthDayYear
Date
Parent/Guardian Signature
Should be Empty:

"I challenge the darkness if nothing else, then at least around myself, I will not let it settle"

School Application Form

Parent / Legal Custodian Information

File Upload

Health History

Registration Fee:*

Registration Fee: