School Enrollment Form
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22590 Portree Way
PO Box 430
École les Aiglons
Garibaldi Highlands BC V0N 1T0
Conseil scolaire francophone de la Colombie-Britannique (S.D. 93)
Telephone: (604) 898-3715
Fax: (604) 898-1535
Enrollment Form
STUDENT
ALERT
Legal last name
Date
Grade
Legal first name
PREVIOUS SCHOOL
Usual last name
District
School
Preferred first
Address
Middle names
Gender
(M/F)
Telephone
Date of birth
(DD/MM/YYYY)
ABORIGINAL ANCESTRY INFORMATION
Proof of age document
Home telephone
No
Yes
PROPERTY ADDRESS
If yes
Off reserve
On reserve (band name)
Address
MEDICAL INFORMATION
Apt
Municipality
Province
Postal code
Doctor's name
MAILING ADDRESS
(if different from property address)
Telephone
CareCard number
Visual impairment
(Y/N)
Problem description
LANGUAGES & OTHER INFORMATION
Eyeglasses
(Y/N)
Contact lenses
(Y/N)
First language
Hearing impairment
(Y/N)
Hearing aid
(Y/N)
Language spoken at home
Problem description
Language most used
Allergies
(Y/N)
EpiPen
(Y/N)
Country or province of birth
If yes, please list allergies and required treatment
City of birth
Citizenship
Immigration status
AUTHORIZATIONS
Asthma
(Y/N)
Bronchodilator
(Y/N)
I accept that information about my child (name, address,
Medication
grade, telephone, pictures, audio and video recordings) be
released, if necessary, for the following school-related
Diabetes
(Y/N)
Requires insulin
(Y/N)
activities:
Epilepsy
(Y/N)
Type
P.A.C. (telephone directory)
(Y/N)
Medication
School transportation
(Y/N)
Heart condition
(Y/N)
School pictures
(Y/N)
Problem description
Website
(Y/N)
Is your child able to fully participate in the school's physical education
Media (TV, radio, newspaper)
(Y/N)
program?
(Y/N)
Field trips
(Y/N)
Other pertinent information
I certify that the information on this form is correct.
Parent / Guardian signature
Date
The information on this form is collected under the authority of the British Columbia School Act. Information is used by the District for Ministry of
Education reporting, demographic, enrollment, budget, facility and operational analyses. It will be kept secure and confidential in accordance with the
Freedom of Information and Protection of Privacy Act.
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