Name of Applicant

Surname

Given Name

Usually Called

Home Address

City

Province/State

Postal/Zip Code

Phone Number

Place of Birth

Citizenship

Date of Birth

Present Grade

Grade Applying For

Parent Information (Father)

Father's Name

Phone

Cell Phone

Fax

Home Address

City

Province/State

Country

Postal/Zip Code

Business Title

Company Name

Company Telephone

Company Fax

Company Address

Company City

Company Province/State

Company Country

Company Postal/Zip Code

Company Email

Parent Information (Mother)

Mother's Name

Phone

Cell Phone

Fax

Home Address

City

Province/State

Country

Postal/Zip Code

Business Title

Company Name

Company Telephone

Company Fax

Company Address

Company City

Company Province/State

Company Country

Company Postal/Zip Code

Company Email

Child Information

Child lives with:

Correspondence to:

Guardian's Name

Phone

Business Phone

Home Address

City

Province/State

Country

Postal/Zip Code

Child's Current School

School Address

School City

School Province/State

School Country

School Postal/Zip Code

Citizenship

Primary Language

Fluency In

Passport Held

Date of Issue

All students are required to show proof of one of the following:

Do you have relatives that attend SMLS?

State of Health

Please list any physical disabilities, allergies, eyesight, etc.

General

How did you hear about St. Mildred's-Lightbourn School?

Which present SMLS students (if any) are known to you?

Has your child undergone any assessment in the following areas:

Briefly describe those specific areas of learning in which you feel your child is particularly strong or requires special attention.

Is there any information about your child's background which you think may help the school meet her needs?

Application Fee

An application fee of $150.00 must accompany each application. This non-refundable fee helps defray administration and testing costs. Upon receipt, your application will begin the review process. Applicants will be notified of the status of their file at the appropriate time. Acceptance to St. Mildred's-Lightbourn School is at the discretion of the School. Once a student is accepted, her parents must comply with the financial terms of enrolment as outlined in the Financial Handbook and the student must abide by the rules, policies, and regulations of the School. Failure to do so can be cause for dimissal. The School reserves the right not to re-enrol a student.

Please mail a cheque for $150.00, a copy of the applicant's birth certificate and latest report card to: Admissions Office, St. Mildred's-Lightbourn School, 1080 Linbrook Road, Oakville, Ontario L6J 2L1

Consent

I am aware that SMLS is keeping personal information as outlined for reasons disclosed. I am aware that the members of the staff of SMLS and/or volunteers / suppliers or auditors may access this information. I give my consent for this information to be collected and disclosed as outlined to me.