Webtree-style Intake

Student Application Form

Layout and section order follow the provided PDF: student information, school information, general information, family information, student profile, and program choice. Submission writes into the existing unified students record set.

Complete the registration form. Required fields: first name and last name.

Part 1: Student Information

Last name First name Middle name Preferred name Date of birth Gender Address Citizenship status Country of citizenship First language Place of birth Other languages Mobile phone Email

Part 2: School Information

Current grade Grade applying for Desired year of entry Current school City Country Expected entry term IELTS score, if any Has repeated a grade? Date of arrival in Canada

Part 3: General Information

How did you hear about Webtree Academy?

Which Webtree Academy students and/or families are known to you?

Name Relation

Are there any other children in your family?

Name Relation

Part 4: Family Information

Mother

Name Address Phone number Email Occupation

Father

Name Address Phone number Email Occupation

Guardian

Name Address Phone number Email Occupation

Applicant lives with Billing name Billing relation Billing address

The child can be released to either parent Emergency contact name Relation Email Phone (day) Phone (evening)

Authorize release of information

Application and Admission information Academic Information Financial information

Release to name Agency / Friend / Guardian

Part 5: Student Profile

Regular school activities If no, please explain Any allergies If yes, please explain Receiving medication If yes, please explain Other health or development information If yes, please explain Ontario Health Coverage (OHIP) Health card # Permission to go to nearest hospital

Part 6: Program Choice

Elite University Bridging Program Regular Ontario Secondary School Diploma Program

Checklist from PDF is informational only: completed application form, most recent school report, passport copy, CAD $300 application fee.

Student signature name Date

Mother signature Father signature Guardian signature

Open questionnaire only