Transfer Application Form For Richmond Residents

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SA-23
Revised: 24-OCT-2016
TRANSFER APPLICATION FORM
FOR RICHMOND RESIDENTS ONLY
SCHOOL YEAR 2017/18
❏ Catchment School ❏ Central Registration
Staff Initial _______
_______
Date ____________, 2017
Please print clearly in black ink.
FOR REQUESTED SCHOOL USE ONLY
_____________________________
______________________________
1
Choice REQUESTED SCHOOL
2
Choice REQUESTED SCHOOL
st
nd
School Year 2017/18 - Staff Initial: _______
Application: date __________ time _______
_________________ ___________
______________________________
CURRENT SCHOOL YRS ATTEND
CATCHMENT SCHOOL
For
❏ Male ❏ Female
Student Name: ____________________
________________________
Grade in 2017/18 ____
Last Name
First Name
Birthdate: _____/_____/_____
Current ELL Level _________
❏ Resource Support: __________________
day month year
HOME ADDRESS: _______________________________________________
RICHMOND, BC
__________________
Number
Street
Postal Code
PROGRAM:
❏ English
❏ Early French Immersion
❏ Late French Immersion
❏ Montessori
❏ Sibling attending requested school:
Name ______________ _
_____________________
Grade in 2017/18 ____
Last Name
First Name
Please list the reason(s) why you are applying to the requested school:
FATHER: _______________________________________
_____________________
______________________
Name
Home Phone
Cell. Phone
MOTHER: ______________________________________
_____________________
______________________
Name
Home Phone
Cell. Phone
LEGAL GUARDIAN: ______________________________
_____________________
______________________
Name
Home Phone
Cell. Phone
I wish to apply for a transfer for the student listed above. I am the student’s:
❏ Parent
❏ Legal Guardian
If you’re a legal guardian, please list the Court Order: # ______________________
__________________________, 2017
____________________________
Date Submitted
Parent or Legal Guardian Signature
FOR OFFICE USE ONLY
❏ The above transfer application has NOT been granted.
❏ The above transfer application has been granted for the 2017/2018 school year.
Comment ________________________________________________________________________________________
________________________________________________________________________________________
_____________________, 2017
_________________________________
Decision Date
Principal’s Signature – Requested School

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