1071 SE Marine Drive Vancouver, B.C. V5X 2V5
Tel: 604 430 1313 Fax 604 324 1469
www.gurunankelementary.com
Name of Student
Date of Birth
Sex: M / F PEN
Transferring School:
Grade:
Will you require bus service? Yes No # of children at this stop:
Address:
Mother/Guardian’s Name:
Home Tel: Work Tel: Cell:
Email:
Father/Guardian’s Name:
Describe your household:
# of children in home: Ages:
# of children in home: Relation to student
Are there any legal alerts regarding this child? Yes No (attach court documents).
Are there any medical alerts regarding this child? Yes No (attach relevant information).
Emergency Contact: Tel:
Relationship to child:
Family Doctor: Tel:
Family Dentist: Tel:
Are there any other specialists who attend to your child? Yes No (attach information,)
Languages used at home:
Written: English Yes No Punjabi Yes No Other:
Spoken English Yes No Punjabi Yes No Other:
Does the student have any music training?
Do you have any concerns with learning or behavioral issues? Yes No (attach comments).
Supporting Documents:
Birth Certificate Yes No Immunization Yes No Immigration Status Yes No
Report Cards Yes No MSA Card Yes No
Fees:
Registration Deposit ($100) Yes No School Uniform ($125) Yes No
Supply Fee ($100) Yes No Bus Fee : $100
Tuition: ($125 per month). Indicate payment method: Yes No
Post-dated cheques to June 2008 made out to Guru Nanak Elementary School or Vancity Direct Deposit
Pre Pay for year for 5% discount Yes No