Application Form for L’Héritage Français

Application Form for L’Héritage Français

Please Fill in all Fields
Student Name

First NameLast Name
Date of Birth

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityProvince

Zip Code
Birthplace
Country of Citizenship
Mother/Guardian Name

First NameLast Name
Occupation
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Contact Email
example@example.com
Father/Guardian Name

First NameLast Name
Occupation
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Contact Email
example@example.com
Student lives with:
List the last 2 schools your student has attended starting with the most recent.
Grade
Year Attended
Name of School
School Address
City
State
Has your child ever:
Repeated a grade?
If Yes, which grade level?
Skipped a grade?
If Yes, which grade level?
Expelled from school?
If Yes, when and for what reason?
What language did your child learn when first starting to speak?
What language does you child most frequently speak now?
What languages are most often spoken at home?
How did you hear about our school?
Parent/Guardian Name

First NameLast Name
Signature
Submission Date

MonthDayYear
Should be Empty: