Kempenfelt Bay School

Applicant Information

First Name^*

Last Name^*

Entry Grade^*

Year of Entry^*

Current School^*

Current Grade^*

Parent Information

Father's Full Name^*

Father's Email^*

Father's Mobile Phone^*

Father's Profession/Occupation^*

Name of Father's Business/Firm *^*

Address^*

Postal Code^*

City^*

Mother's Full Name^*

Mother's Email^*

Mother's Mobile Phone^*

Mother's Profession/Occupation^*

Name of Mother's Business/Firm *^*

Full Address (if different from above)

Family Information

Application Contact^*

Father Mother Both

Who should be contacted regarding the application?

Parental Marital Status^*

Custody

Please indicate who has legal custody of the applicant

Billings^*

Father Mother Both

Please select who should receive billings

Applicant Academic & Medical Information

Programme Information^*

French Immersion Gifted Program ESL Other

Is the applicant in any of the following streams?

Psychoeducational assessment and/or an IEP^*

Does your child have a psychoeducational assessment and/or an IEP?

Please note that admissions office requires a copy of the applicant's psychoeducational assessment and/or an IEP if there is one available.

Has the applicant skipped or repeated a grade?^*

Why have you applied to join Kempenfelt Bay School?^*

Does the applicant require medication during the day or do they have any allergies? ^*

Medication Information continued

If you selected Yes, please indicate the medication or allergies the applicant has.

How did you hear about Kempenfelt Bay School?

How did you hear about Kempenfelt Bay School?^*

Friend Current or Past KBS Family Colleague Internet Research Social Media Other

Most recent report card

Please include the applicant's most recent report card

June 2019 Report Card

Please attach the applicant's June 2019 Report Card

Recent photo^*

Please attach a recent photo of the applicant

Proof of Age^*

Please attach a copy of the applicant's birth certificate or passport

If this application is accepted by Kempenfelt Bay School, I/We hereby agree to be bound by the rules,
regulations, behavioural and financial expectations of Kempenfelt Bay School.

Please accept the terms & conditions to submit this form.