Student Registration SELF-IDENTIFICATIONThis section is VOLUNTARY - Parents / Guardians and / or students are encouraged to self-identify. By doing so, this enables the Department of Education and Early Childhood Development, Regional Centres for Education and CSAP to have a greater awareness of the diversity of the student population and the communities served and to better meet the educational needs of students.INDIGENOUS - For the purpose of this form, Indigenous persons are those who consider themselves to be Mi'kmaw / other First Nations, Metis, or InuitYES - student is of Indigenous AncestryNO - student is not of Indigenous AncestryTo which group does the student belong?Mi'kmaw / other First NationsMetisInuitANCESTRYPlease Indicate the ancestry with which the student most identifies. Select all that apply. Acadian descent African descent Asian descent East Asian descent European descent Middle Eastern descent Not Listed, Other Ancestry - Please specify:PROGRAM INFORMATIONNOTE: Some programs, such as Early French Immersion are only offered at certain schools. Should you have questions, please contact Central Office.Program*Select ProgramPre-PrimaryEnglish ProgramEarly French Immersion - Begins in ElementaryLate French Immersion - Begins in Grade 7Intensive FrenchNOTE: Contact school administration for assistance completing this section if needed. Pre-Primary School*Select Pre-Primary SchoolCarletonClark's HarbourDigby ElementaryDrumlin HeightsERMESForest Ridge AcademyHillcrest AcademyIslands ConsolidatedLockeport ElementaryMeadowfieldsPlymouthPort MaitlandWeymouthYarmouth Elementary SchoolWill you be interested in exploring options for French Immersion in Primary?*YesNoEnglish Program School*Select SchoolBarrington HighCarletonClark's HarbourDigby ElementaryDigby NeckDigby Regional HighDrumlin HeightsERMESForest Ridge AcademyHillcrest AcademyIslands ConsolidatedLockeport ElementaryLockeport Regional HighMaple Grove Ed. CentreMeadowfieldsPlymouthPort MaitlandShelburne Regional HighSt. Mary's Bay AcademyWeymouthYarmouth Elementary SchoolYarmouth HighEnglish Program Grade*Select GradePrimaryGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12Early Immersion School*Select Early Immersion SchoolDigby ElementaryDrumlin HeightsMeadowfieldsPlymouthWeymouthYarmouth Elementary SchoolNOTE: If you are NOT in the catchment area of one of these schools YOU are responsible for your students transportation to the school or nearest bus stop. Please contact the school for further information. Early Immersion Grade*PrimaryLate French Immersion School*Select Late Immersion SchoolBarrington HighMaple Grove Ed. CentreShelburne Regional HighNOTE: If you are NOT in the catchment area of one of these schools YOU are responsible for your students transportation to the school or nearest bus stop. Please contact the school for further information. Late French Immersion Grade*Select GradeGrade 7Intensive French School*Select Intensive French SchoolMaple Grove Ed. CentreNOTE: If you are NOT in the catchment area of one of these schools YOU are responsible for your students transportation to the school or nearest bus stop. Please contact the school for further information. Intensive French Grade*Select GradeGrade 6PLEASE NOTE Early French Immersion is ONLY offered at the following schools: Digby Elementary, Weymouth, Meadowfields, Yarmouth Elementary, Plymouth, and Drumlin Heights. Should you reside outside of the catchment area of these schools and intend to register your child in the Early French Immersion Program for Grade Primary, you have the option of completing an Application for Student Transfer form for Pre-Primary and your request will be reviewed. (We could provide a link to the form) NOTE: An approved transfer is only applicable for the current school year with re-application being necessary for each school year. It also does not guarantee transportation. STUDENT INFORMATIONLegal Name*MUST match birth certificate, passport, immigration papers, legal name certificate, or adoption documents. First Middle Last Gender*Select GenderF (Female)M (Male)X (Non-binary or another gender identity)Birth Date* Date Format: MM slash DD slash YYYY Proof of IdentityAt a later date you will need to show School Staff proof of your child's identity. This could be a Birth Certificate, Passport or Immigration Papers. You should get started on this right away as it can take time to obtain if you don't already have one of the above. I have read and understand the above.Civic Address* Street Address Address Line 2 Town or Community Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Mailing Address: Same as Civic Address Mailing Address Street Address Address Line 2 Town or Community Province AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Home Phone / Contact Number*Student's Cell PhoneLanguage Comprehension* English French Language most often spoken in the home* Arabic English French Gaelic Mi'kmaw Other Language Other - Please specify*TechnologyDoes the student have access to internet in the home?*YesNoIs the internet access in the home high speed internet?*YesNoDoes the student have access to an internet connected device?*YesNoType of internet connected device (select all that apply):* Phone Tablet or IPad Desktop or Laptop Other CUSTODY ARRANGEMENTSMUST BE COMPLETED ANNUALLY; appropriate legal documentation shall be provided to the school.Are special custody arrangements requested for this student at school?*YesNoDescription / Details - Include special instructions:PARENT / GUARDIAN INFORMATIONParent / Guardian Information Name Relationship Actions Edit Delete There are no Parents / Guardians. Add Parent / Guardian Maximum number of parents / guardians reached. ADDITIONAL EMERGENCY CONTACT(S)Additional Emergency Contact Name Relationship Actions Edit Delete There are no Additional Emergency Contacts. Add Additional Emergency Contact Maximum number of additional emergency contacts reached. MEDICAL INFORMATIONMUST BE COMPLETED ANNUALLYDo you have a family Doctor?*YesNoDoctor's Name*Doctor's Phone*Health Card Number*Health Card Expiry Date* Date Format: MM slash DD slash YYYY MedicAlert Number - If ApplicableDoes the Student have Health Care Needs or a Medical Diagnosis(es)?*YesNoPlease check one or more of the following:*NOTE: Checking any of the below requires further program-planning meetings and / or documentation (e.g. Health Plan of Care, Administration of Medical Forms, etc.) Anaphylaxis / Life Threatening Allergy(ies) Asthma Seizures Administration of prescribed medication is required during the school day. Diagnosed Medical Illness Catheterization Diabetes Tube Feeding Other Other Medical Concerns - Please Specify:*SIBLINGSPlease list all children in your family who attend school. Sibling(s) Name School Grade Actions Edit Delete There are no Siblings. Add Sibling Maximum number of siblings reached. TRANSPORTATION - BUSSINGIs bus transportation required?*YesNoINTERNATIONAL / IMMIGRANT STUDENT INFORMATIONDocumentation to verify status in Canada and proof of medical insurance to be provided at time of registration.Is the Student an International or Immigrant?*YesNoPlease select ONE of the following:*Nova Scotia International Student Program Participant - Short Term - less than 3 months.Nova Scotia International Student Program Participant - 3 months or moreFee-Paying Student - Not part of NSISP or an Approved Exchange Program AND has a Study PermitFee-Paying Student - Not part of NSISP or an Approved Exchange Program AND is studying less than 6 months without a study permitExchange Student - Participating in an exchange through an approved student exchange programPermanent ResidentDependent of a temporary resident - Parent has a WORK permitDependent of a temporary resident - parent has a STUDY permitRefugee ClaimantPermit Valid Until:* Date Format: MM slash DD slash YYYY Citizenship*Medical Insurance*YesNoSELF-IDENTIFICATIONThis section is VOLUNTARY - Parents / Guardians and / or students are encouraged to self-identify. By doing so, this enables the Department of Education and Early Childhood Development, Regional Centres for Education and CSAP to have a greater awareness of the diversity of the student population and the communities served and to better meet the educational needs of students.INDIGENOUS - For the purpose of this form, Indigenous persons are those who consider themselves to be Mi'kmaw / other First Nations, Metis, or InuitYES - student is of Indigenous AncestryNO - student is not of Indigenous AncestryTo which group does the student belong?Mi'kmaw / other First NationsMetisInuitANCESTRYPlease Indicate the ancestry with which the student most identifies. Select all that apply. Acadian descent African descent Asian descent East Asian descent European descent Middle Eastern descent Not Listed, Other Ancestry - Please specify:FRENCH FIRST LANGUAGE EDUCATION ELIGIBILITYOne of the ways you may access the French first language education is under Section 23 of the Canadian Charter of Rights and Freedoms as an "entitled parent". Under the the Nova Scotia Education Act, children of an entitled parent are entitled to be provided a French first language program. Clause 3(l)(h) of the Act defines "entitle parent" as follows: i. Whose first language learned and still understood is French, or ii. who received his or her primary school instruction in Canada in a French first language program, or iii. of whom any child has received or is receiving primary or secondary school instruction in Canada in a French first language program. As a parent, do YOU meet at least ONE of the above criteria?YesNoDo not knowNOTE: French first language education is NOT a French Immersion ProgramYou are advised that future children of your child may loose their right to an education in the French first language if your child does not attend a French first language school. In Nova Scotia, French first language education is only offered by the Francophone school board, the Conseil scolaire acadien provincial (CSAP). Representatives from CSAP are available to answer any questions you have regarding French first language education and to help you determine if you are an entitled parent. You may also contact the CSAP at 902-471-0082, 902-769-5458, 1-888-533-2727, info@csap.ca, or visit the CSAP website at www.csap.ca. Yes, forward my name, home phone, and email address to the CSAP so that a representitive can contact me with more information about French first language program.PRE-PRIMARY INFORMATIONRegulated Childcare Disclosure*Has your child previously attended a regulated (licensed) child care program?YesNoName of Centre*Early Intervention Disclosure*Has your child previously been supported by an early intervention program (ex: Nova Scotia Early Childhood Development Intervention Services (NSECDIS); Early Intervention Behavioural Intervention (EIBI); Nova Scotia Hearing and Speech, etc)?YesNoName of Program(s):*FINAL QUESTIONSDeclaration of Information* I / We certify that all of the information provided on this registration form is correct.