photograph
if available


School Start month requested:

Check (ü) one

September     _____________
November         _____________
February         _____________
April        _____________



1. PERSONAL INFORMATION

Name: ___________________________________________________________
family name first name

Date of birth: ____________________ Age: ____________
        day/month/year

Sex: Male: _______        Female: _____

First Language at home: ____________________________________

Other languages: _________________________________________

Address in Home Country:

__________________________________________________________________
Street & Number
__________________________________________________________________
City Country Code

Telephone number: ___________________________


Fax number: ________________________________

Emergency Contact in Home Country:

Name: _____________________________________

Telephone number: __________________________

Fax number: ________________________________

2. ACADEMIC INFORMATION


Grade in which currently enrolled: ___________________________

Name & location of last school attended:
In home country: ____________________________________________________________
School City
In Canada: __________________________________________________________________
School City

Are you planning to continue your schooling to college/university level? ____________

If yes, where? _______________________________________________________________



Check (ü) the community where you wish to attend school:
Squamish         _____________
Whistler         _____________
Pemberton        _____________


Note: Placement in a school of choice is not always possible. The Howe Sound School Board reserves the right to determine final placement.

For which grade are you applying? ____________

English as a Second Languages Services required: Yes: __________ No: __________

List any physical handicaps the school should be aware of:

_________________________________        _____________________________________


3. ACCOMMODATION INFORMATION


It is a mandatory regulation that any International student under the age of 19 years must live with a “responsible adult” who is 25 years of age or older.

Students who are under 16 years of age must have guardianship papers notarized. These papers will be forwarded to applicants to complete, once they have been accepted into the program.

a) I would like homestay arrangements to be made by the homestay coordinator of the International Education program. Please send me the information and application for the homestay program.

OR

b) My child will be living with the following person(s) who is over the age of 25:

_______________________ ________________ ___________________ Surname (Family Name) First Relationship
__________________________________________ (_____)_____________ Street Telephone (Home)

        _____________________________ ______________ ___________________
City Province Postal Code
        _____________________________ ____________________
Telephone (Work) Fax



        
FOR OFFICE USE ONLY

Date Received: _______________________

Principal’s appraisal (strengths/weaknesses): ______________________________________

_____________________________________________________________________________

Accepted _______ Not Accepted ________

Principal’s Signature: ____________________________________




Please submit by mail or fax to:

Brian Edwards/Trish Farina

International Education Program

School District No. 48 (Howe Sound)

P.O. Box 250,

Squamish, British Columbia,

Canada, V0N-3G0

Brian Edwards Trish Farina

Telephone 1-604-892-5228

Fax 1-604-892-1038

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