ON-LINE APPLICATION
 


 
Child's Information
 *Surname
 *Given Name
 *Date Of Birth   (MM/DD/YYYY)
   Present School
 *Current Grade
 Address
 *Street
 *City
 *Province
 *Postal Code
Emergency Contact
 (If Parents/Guardians are unavailable)
  Name
  Relationship to   student
  Telephone
Doctor's Information
  Doctor's Name
  Telephone
  Health Card#
  Health Concerns
  Date(MM/DD/YYYY)
  Authorized By
Mother's Information
 *Surname
 *Given Name
  Occupation
Address
  Street
  City
  Province
  Postal Code
Contact Info
 *Home Tel
  Business Tel
  Celluar
  Fax
  E-Mail
Father's Information
 *Surname
 *Given name
  Occupation
Address
  Street
  City
  Province
  Postal Code
Contact Info
 *Home Tel
  Business Tel
  Cellular
  Fax
  E-Mail
Administrative Details
  Please indicate one(maximum 2) email address(es) where you wish to receive
  communications.
  Referred by
  Date(MM/DD/YYYY)
  Form Completed by
 *Verification E-Mail
 

   
2999 Dufferin Street Toronto, ON Canada M6B 3T4 Office:1-416-487-7381 Fax:1-416-487-8190