Student Application Form

Introduction
Student Information
Family Information
Religious Information
Medical Information
Scholastic Information
General Information

Introduction

This is the on-line application form for Prairie Christian Academy School.

This form must be filled out by the parent(s) or guardian(s) of the child(ren) who this application is for.

Family Information

Marital Status

Mother

Father

Father's Information

Father's First Name

Middle Name

Last Name

Father's Email

Father's Mobile Number

Place of Employment

Position

Work Phone

Mother's Information

Mother's First Name

Middle Name

Last Name

Mother's Email

Mother's Cell Phone

Place of Employment

Position

Work Phone

Names of children not attending

Any other children?

Yes

Name of children not attending

Name	Age

Emergency Contact

If more then one person, please enter in order of priority.

Emergency Contact's Information

First Name	Last Name	Phone Number

Religious Information

Please enter the information regarding the church you are attending.

Do you attend church?

Yes

Pastor's First Name

Pastor's Last Name

Church Name

Church Phone

Medical Information

Family Physician

Phone Number

-= Child One: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

-= Child Two: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

-= Child Three: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

-= Child Four: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

Scholastic Information

-= Child One: =-

Has student ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

-= Child Two: =-

Has ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

-= Child Three: =-

Has ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

-= Child Four: =-

Has ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

General Information

How did you hear about Prairie Christian Academy?

Reason for choosing Prairie Christian Academy?

International Student

Is the Applicant or Applicants an international student(s)?

Yes

International students may not qualify for government funding and therefore may be required to pay regular tuition. Please read the following and indicate which criteria the international student would fall under.

International Student Criteria

At least one parent has a valid work permit and is moving to an address in Saskatchewan (the student lives with the parent holding the work permit)

At least one parent has a valid study permit and is registered in a full time degree or diploma program (short term EAL courses are excluded).

The following students would not qualify as International Students:

*** The student and or parents are visiting Canada. In this case we would not count the student for funding purposes.
*** Students in Canada for the sole purpose of education and are not accompanied by parents. In this case we would not count the student for funding purposes.

Please contact the Prairie Christian Academy school office for current international non-funded tuition rates (306) 652-2230

Introduction
Student Information
Family Information
Religious Information
Medical Information
Scholastic Information
General Information

Introduction

This is the on-line application form for Prairie Christian Academy School.

This form must be filled out by the parent(s) or guardian(s) of the child(ren) who this application is for.

Family Information

Marital Status

Mother

Father

Father's Information

Father's First Name

Middle Name

Last Name

Father's Email

Father's Mobile Number

Place of Employment

Position

Work Phone

Mother's Information

Mother's First Name

Middle Name

Last Name

Mother's Email

Mother's Cell Phone

Place of Employment

Position

Work Phone

Names of children not attending

Any other children?

Yes

Name of children not attending

Name	Age

Emergency Contact

If more then one person, please enter in order of priority.

Emergency Contact's Information

First Name	Last Name	Phone Number

Religious Information

Please enter the information regarding the church you are attending.

Do you attend church?

Yes

Pastor's First Name

Pastor's Last Name

Church Name

Church Phone

Medical Information

Family Physician

Phone Number

-= Child One: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

-= Child Two: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

-= Child Three: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

-= Child Four: =-

Does have a medical condition and/or allergies for which they require special needs and/or medication?

Yes

Please explain

Scholastic Information

-= Child One: =-

Has student ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

-= Child Two: =-

Has ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

-= Child Three: =-

Has ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

-= Child Four: =-

Has ever had disciplinary difficulty in school?

Yes

Please explain:

Please indicate academic level of student's previous work

General Information

How did you hear about Prairie Christian Academy?

Reason for choosing Prairie Christian Academy?

International Student

Is the Applicant or Applicants an international student(s)?

Yes

International Student Criteria

At least one parent has a valid work permit and is moving to an address in Saskatchewan (the student lives with the parent holding the work permit)

At least one parent has a valid study permit and is registered in a full time degree or diploma program (short term EAL courses are excluded).

The following students would not qualify as International Students:

Please contact the Prairie Christian Academy school office for current international non-funded tuition rates (306) 652-2230

Student Application Form

Introduction

Student Information

-= Child One =-

-= Child Two =-

-= Child Three =-

-= Child Four =-

Family Information

Father's Information

Mother's Information

Names of children not attending

Emergency Contact

Religious Information

Medical Information

-= Child One: =-

-= Child Two: =-

-= Child Three: =-

-= Child Four: =-

Scholastic Information

-= Child One: =-

-= Child Two: =-

-= Child Three: =-

-= Child Four: =-

General Information

International Student

Introduction

Student Information

-= Child One =-

-= Child Two =-

-= Child Three =-

-= Child Four =-

Family Information

Father's Information

Mother's Information

Names of children not attending

Emergency Contact

Religious Information

Medical Information

-= Child One: =-

-= Child Two: =-

-= Child Three: =-

-= Child Four: =-

Scholastic Information

-= Child One: =-

-= Child Two: =-

-= Child Three: =-

-= Child Four: =-

General Information

International Student