Student Application Form

First Name: *

Middle Name:

Last Name: (as it appears on passport or birth certificate) *

Student Email Address:

Student Mobile Phone

Country Code Area Code Phone Number

Address: *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Grade Entering: *

For Which School Year? *

(A full school year runs from August to June.)

Date of Birth: *

Day Month Year

Age: *

Gender: *

Male Female

Birthplace: *

Citizenship: List all citizenships held *

Social Insurance or Social Security #:

Religious Affiliation: *

Home Church: *

Baptized: *

Yes No

Student Photo: Please upload a recent picture of yourself.

Upload a File

Your application will not be reviewed until we have your photo. If you can't attach it to this form, please email your picture to admissions@fountainview.ca

Please upload a copy of your birth certificate.

Upload a File

This is one of the items needed for the application process. If you can't attach it to this form, please email it to admissions@fountainview.ca

Student Acknowledgement

I acknowledge that I have answered the above questions as accurately as possible, I have read and understand the student handbook, and if I am accepted as a student, I pledge to uphold the educational principles and practices of Fountainview Academy as outlined in the student handbook.

Student Signature *

Clear

To be completed by the student in their own words and with no translation help. An essay completed by the student answering the following questions: Why you wish to attend Fountainview Academy? A description of your Christian experience. How your parents feel about your desire to attend Fountainview Academy? Any other information that you feel will aid the application process.

Parent/Guardian 1 *

Legal First Name Legal Last Name

Relationship: *

Mailing Address: *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Telephone Number (include country code and area code) *

Home Phone

Mobile Phone

E-mail: *

Parent/Guardian 2

Legal First Name Legal Last Name

Relationship:

Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Telephone Number (include country code and area code)

Home Phone

Mobile Phone

E-mail:

Email grades to the email above Email financial statements to the email above

Has your child had any major illnesses, surgeries or chronic diseases that we should be aware of in the event of an emergency? *

If yes, please describe below:

Does your child suffer from allergies? *

If yes, please list them including any reactions they may have had.

Please list schools or home school programs attended from the 8th grade to the present (current year): *

Year

School

Address

Phone

8

9

10

11

Please send us copies of your child’s grades or grade reports (in English or with English translation) from 9th grade to the present. Please upload the grade reports, email them to admissions@fountainview.ca, or if need be, send by mail. The reports do not have to be sent straight from the child's school.

We may require course descriptions (in English or with English translation) to be submitted if it is not clear how the courses line up with our requirements.

Homeschoolers who don't have transcripts or grade reports from a homeschooling program should submit a list of courses taken, being sure to describe course types. For example, instead of saying "Math," write "Algebra 1 by Teaching Textbooks," or instead of "Science," say "Biology from A Beka" etc.

Upload transcript/grade report

Upload a File

Upload another transcript/grade report, if needed

Upload a File

Upload another transcript/grade report, if needed

Upload a File

Does your child have any difficulty learning? *

If yes, please explain:

Does your child desire special help in any subject? *

If yes, which subject(s)?

If your child plays a musical instrument, which kind and for how long? *

Do you have an unpaid bill at any other school? *

If yes, what amount?

School Name:

School phone number:

School Address:

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parental Acknowledgement

I have read the Student Handbook (Handbook copy ) and I understand the educational philosophy of Fountainview Academy. I desire to have my child attend Fountainview Academy, and I willing pledge to support the high ideals and standards of the school. I agree to assume all financial responsibility for the applicant.

Parent Signature *

Clear

Skype ID or Name:

Since we often do interviews over Skype, please list your Skype ID/name, or email registered with Skype. If you do not have Skype - just say "not applicable"

How did you find out about us?

If other, where?

Would you like to pay the $25 application fee now by MasterCard or Visa?

Yes No, I'll pay later or with a different method

Application Fee by Credit Card

CAD Application Fee

Payment Method

	What is PayPal?

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Date of Birth:

Type a question

Student Application Form

Personal Essay

Parents/Guardians

MEDICAL INFORMATION

Financial Information

Educational Information

Heading

Fountainview Academy