Application for Admission

Application for Admission
FOR OFFICE USE ONLY

Date ReceivedApplication: Accepted / DeniedPrincipal's Initials
Student Information
Student Name

Legal Last NameLegal First NameMiddle Name(s)
Usual Last Name (if different from legal last name)Preferred First Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2 (include PO Box)

CityProvince

Postal Code
Home Phone Number
Format: (000) 000-0000.
Language Spoken at Home
Aboriginal Ancestry?

Yes or NoBand NameBand Number
Status
Country of Birth
Citizenship
Student lives with:
Are there any custodial or legal arrangements regarding the student of which the school should be aware? (copy of court/custodial documents should be attached)
List previous schools attended (last one first):

School NameAddressGrade(s) Completed
Other children in the family (list name in order of birth, oldest first):

NameDate of BirthMale / Female
AgeGradeSchool Attending
Parent or Legal Guardian Information
Mother/Guardian

Legal Last NameLegal First NameMiddle Name(s)
Address

Street Address

Street Address Line 2 (include PO Box)

CityProvince

Postal Code
Country of Birth
Home Phone Number
Format: (000) 000-0000.
Work Phone Number
Format: (000) 000-0000.
Cell Phone Number
Format: (000) 000-0000.
Email Address

Faith or Religious Affiliation
Faith or Religion:
Denomination:

If Seventh-day Adventist, please complete the following:

Rows	Student	Father	Mother	Guardian
Baptized Member

Membership at which Adventist Church:
Pastor's Name:
Church currently attending:
Pastor/Minister:
Any additional comments
Emergency Contact Person Information
Emergency Contact #1 (if unable to reach parents):
Relationship to Student:
Home Phone No.:
Work Phone No.:
Cell Phone No.:
Does this contact have permission to pick up student?
Emergency Contact #2 (if unable to reach parents):
Relationship to Student:
Home Phone No.:
Work Phone No.:
Cell Phone No.:
Does this contact have permission to pick up student?
Out of Town Emergency Contact:
Relationship to Student:
Home Phone No.:
Work Phone No.:
Cell Phone No.:
Acceptable Use of Technology Agreement
At Avalon Adventist Christian Academy we believe that technology can be a powerful tool to enhance learning, enabling students to access information and collaborate with others across the school, community, and the internet. We believe all students, staff and parents must be good digital citizens by following standards of acceptable use when using either school-owned technology (software, hardware, network), or their own personal electronic device for school purposes or when connected to school board networks.

All students must have a current Technology User Agreement signed and in place prior to being allowed any school network or electronic device access. This declaration is an additional document that outlines the standards of acceptable use for students using a school board or personal electronic device. Once signed, it will act as an agreement between Avalon Adventist Christian Academy and the student/parent/guardian.
Student Name
Parent/Guardian Name
This declaration must be reviewed and signed by both the student and their parent/guardian in order for students to use any electronic devices in a school. This may include a desktop or mobile computer, laptop, table, smart phone, Chromebook, or any other device that has access to the internet.

Student Declaration
As a student at Avalon Adventist Christian Academy I value having access to technology to support my learning. I know that along with this privilege goes great responsibility. To demonstrate my commitment and understanding of the level of responsibility required, I have initialed each of the expectations and guidelines listed below.

Note: Each item must be initialed by the student and his/her parent or guardian to show that together they have reviewed each item and that the student will abide by the rules and expectations laid out for technology use.)

Students may bring in their own personal electronic devices which may be able to connect to the school wireless network. When at school, all of the conditions below apply to electronic devices, whether owned by the school board or brought in by a student.

Rows	Student's initials	Parent/Guardian's initials
I will only connect to the school wireless network with a personal device, and NOT to the school's wired network, nor any other (external) wireless network even though other networks from the neighbourhood might be visible inside the school.
I will turn off all peer-to-peer (music/video/file sharing) software or web-hosting services on my device while connected to the school wireless network and respect the personal information of others.
I will use electronic devices in class or school activities only with a teacher's permission and for appropriate purposes, including texting, IM, internet access, pictures, audio and video recording.
I understand the security, care and maintenance of any device I bring from home or use at school, is my responsibility. I will securely store my device when not in use.
I understand the school is not responsible for the loss, theft, or damage of my personal electronic device. I am fully responsible for my property while it is at school, and I am responsible for school devices if borrowed and taken away from school.
I will exercise appropriate security procedures at all times when using my own devices in conjunction with the school's wireless network.
I understand that I have several electronic resources available to me that have been provided by the school board including a Google Apps For Education account. I agree that I will communicate with school board teachers and staff with officially sanctioned and provided tools and not personal account.
I may use online communication and collaboration tools such as Google Apps For Education, Discovery Education and select Web 2.0 tools, etc. I will use them appropriately for learning purposes.

This is to certify that I, First Name Last Name , have read, understand and initialed this document and will abide by all the acceptable use requirements set forth in this agreement. I agree, that, should I fail to keep my commitment to upholding the standards listed above, I may have my school network and/or school computer privileges revoked either temporarily or permanently. I understand there may be other disciplinary consequences if I breach these school rules.
Student's Signature
Date

MonthDayYear
Date

Parent/Guardian Endorsement
I have reviewed this document and initialed each paragraph with my child. I have discussed the importance of this agreement with my child. My child understands the expectations and responsibilities associated with the proper care and handling of personal devices while at school, as well as the appropriate and ethical use of technology at school. My child is clear that the consequences of not upholding his/her responsibilities will result in his/her technology privileges being withdrawn.
Parent/Guardian Signature
Date

MonthDayYear
Date
Comments
How did you hear about our school?
Why do you want your child/children educated in a Christian School?
Are you prepared to support your child/children in doing regular homework?
Are you prepared to attend regular parent/teacher meetings and student led parent conferences?
Commitment
I/We First Name Last Name First Name Last Name , certify that all of the information that I/we have provided is true and accurate.

I/We accept the Christian education approach offered at Avalon Adventist Christian Academy and acknowledge that we will live in harmony with that philosophy.

I/We agree to read and support the policies and principles as written in Avalon Adventist Christian Academy's Handbook.

I/We also agree to support the administration, teachers and staff in their mission to administer an education and to support the mission, vision and practices of Avalon Adventist Christian Academy.

I/We also understand that failure to meet our obligations to the school may result in the removal of the student from the school.

I/We understand that acceptance of our child/children will depend on the outcome of an informal interview. Availability of space in the school, and completion of this application does not ensure admission to Avalon Adventist Christian Academy.

I/We, the parent(s) or guardian(s) of Student's Name also agree to be responsible for the payment of all fees and charges.
Parent or Guardian's Signature
Parent or Guardian's Name

First NameLast Name
Parent or Guardian's Signature
Parent or Guardian's Name

First NameLast Name
Student's Signature

Privacy
I consent to having Avalon Adventist Christian Academy collect personal information that may include student identification information, birth certificate, legal guardianship, court orders (if applicable), parent's work numbers and email address, behavioral, academic and health information, most recent report card, emergency contact name and number, doctor's name and number, health insurance number and any similar information needed for registration.

I further consent to the use and disclosure of information contained in this form and otherwise collected by or on behalf of Avalon Adventist Christian Academy:

1. For the purpose of establishing, maintaining, and terminating the student's or parent(s)'s relationship with Avalon Adventist Christian Academy;

2. For additional purposes identified when or before personal information is collected; and

3. As otherwise provided in the BC Conference and Avalon Adventist Christian Academy's Personal Information Privacy Policy, a copy of which is available upon request.

I also consent to the collection, use and disclosure of such personal information by and to agents, contractors and service providers of Avalon Adventist Christian Academy.

This information is required in order to register your child at this school and assist the school administration in making an informed decision as to your child's suitability and appropriate placement in the school. It will also allow to respond immediately to an emergency. For more information, the privacy officer for Avalon Adventist Christian Academy is the Principal. The Principal may be reached at 250-949-8243.
Parent or Guardian's Signature
Date

MonthDayYear
Date
Do you give permission for videos/photos to be taken at school of your child/children and/or work samples to be used by the school or BC Conference Office of Education for promotional/publication purposes?
Parent Checklist
Please include the following with your completed application:

Copy of Birth Certificate or Immigration papers for child and parentCopy of Personal Health Number (Care Card) for childImmunization records for childProof of addressDetails of resident status (passport, study permit, etc.) for students born overseasCopies of most recent school reportsCompleted Application Form

Legal Residency of Parent - Form A

If parents are deceased please use Form B
To be completed and signed by a parent or legal (court-appointed) guardian. (If legal guardian, attach copy of court order appointing you as legal guardian.)

LAWFULLY ADMITTED INTO CANADA
I am (please select one):

A Canadian citizen (if not born in Canada, please attach a photocopy of citizenship paper/card)A landed immigrant (attach photocopy of landed immigrant status paper)Lawfully admitted into Canada under one of the following documents (please select the appropriate option and attach photocopy of document:)
Please select the appropriate option:
Provide description of document (must be cleared with Immigration Canada)
RESIDENCY IN BRITISH COLUMBIA I am a resident of British Columbia (please select one):

YESNO I am not a resident of British Columbia
If YES, please provide Residency address (not PO Box):
CONFIRMING SIGNATURE
Parent or Guardian's Name

First NameLast Name
Date

MonthDayYear
Date

Legal Residency of Parent - Form B

To be completed ONLY if parents are deceased, then the have signed by the student OR knowledgeable adult* *(Knowledgeable adult is one who knew the student's parent(s) and has knowledge of the facts respecting their decease and the matters set out in this document.)
Student's Name

First NameLast Name
Student's Name

Middle Name
DECEASED PARENT WAS LAWFULLY ADMITTED INTO CANADA The deceased parent was at the time of death:

A Canadian citizenA landed immigrant
DECEASED PARENT WAS A RESIDENT IN BRITISH COLUMBIA The student's deceased parent was at time of death a resident of British Columbia (please select one):

YES (give full address below)NO They were not a resident of British ColumbiaType option 3Type option 4
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
CONFIRMING SIGNATURE (Student)
Date

MonthDayYear
Date
CONFIRMING SIGNATURE (Knowledgeable Adult)
Date

MonthDayYear
Date
Should be Empty:

Application for Admission

Student Information

Parent or Legal Guardian Information

Student Enrollment

Schooling

Medical

Faith or Religious Affiliation

Emergency Contact Person Information

Acceptable Use of Technology Agreement

Student Declaration

Parent/Guardian Endorsement

Comments

Commitment

Privacy

Parent Checklist

Legal Residency of Parent - Form A

Legal Residency of Parent - Form B