Fill - Free fillable Student-Registration-Form Student Registration Form

Revised January 2020 Research & Strategy Page 1 | 8

Resident / Non-Resident of The Calgary Board of Education (CBE)

Under the Education Act, a student is considered to be a resident of The Calgary Board of Education if the legal guardians / parents

with day-to-day care of the student reside in the City of Calgary and at least one of them is NOT of the Roman Catholic faith.

By signing below, I declare that (check one):

 all legal guardians / parents with day-to-day care of the student identified on this form, are of the Roman Catholic faith

 at least one of the legal guardians / parents with day-to-day care of the student identified on this form, is not of the

Roman Catholic faith

Print Legal Guardian / Parent Name

Signature Legal Guardian / Parent Name

Date (MM/DD/YYYY)

Student Name and Citizen Information

For acceptable identification refer to Proof of Age and Legal Name at the end of this document.

Legal Last Name:

Preferred Last Name:

Legal First Name:

Preferred First Name:

Legal Middle Name:

Preferred Middle Name:

Student Email Address:

Birth Date:

Gender:

☐ Female ☐ Male ☐ Undisclosed ☐ Unspecified

MM

DD

YYYY

Student Home Phone:

Student Mobile Phone:

–

Birth Country:

Home Language:

Student is a Canadian Citizen:

☐ Yes ☐ No

If Canadian Citizen, name of Canadian document (e.g., birth certificate, passport, Canadian Citizenship Certificate):

If not Canadian Citizen:

Name of document (e.g., Permanent Resident, Landed Immigrant, Refugee Claimant, Temporary Resident, Child

of Canadian Citizen, Child of a lawfully admitted permanent or temporary resident, Stepchild of a Canadian or

Temporary Foreign Worker):

Expiry Date of Document:

MM

DD

YYYY

Office Use Only

CBE #:

ASN #:

Resident CBE:

☐ Yes ☐ No

Name of School:

Program:

Lottery:

☐ Yes ☐ No

Expected Start Date:

Grade Entering:

Full Day Kindergarten:

☐ Yes ☐ No

MM

DD

YYYY

Entered by:

Date Entered (MM/DD/YYYY):

Address Verified:

☐ Yes ☐ No

Student Registration Form

Dependent Student

This form is a legal document. It must be completed in its entirety by the legal guardian / parent for students registering in a school

(K-12) in The Calgary Board of Education. The information for each legal guardian (including custodial parents) must be included on

this form. Please print.

Revised January 2020 Research & Strategy Page 2 | 8

Student Address

Provide a home address. If the mailing address is the same, check the box and do not complete the mailing address:

☐ Same

Home Address: Apt / Suite #:

Street:

City:

Province:

Postal Code:

Home Community (in Calgary):

Mailing Address: Apt / Suite #:

Street:

City:

Province:

Postal Code:

Student Medical Information

If the student’s attendance at school may be affected by an existing medical or physical condition, it is your responsibility to complete

and submit the Student Health Plan form to the school.

Does the student have any medical or physical conditions that may affect their attendance at school?

☐ Yes ☐ No

If yes, give a brief description:

Has the Student Health Plan form been completed and submitted to school?

☐ Yes ☐ No

Self-Identify as Indigenous

If you wish to declare the student as Indigenous, select one:

☐ First Nation (status) ☐ First Nation (non-status) ☐ Métis ☐ Inuit

For further information, refer to https://www.alberta.ca/first-nations-metis-or-inuit-student-self-identification.aspx or contact Alberta

Education at 780-427-8501.

Francophone Eligibility

The exercise of Francophone eligibility rights refers to instruction in a Francophone school, NOT a French Immersion school.

According to the Education Act and Section 23 of the Canadian Charter of Rights and Freedoms, a student is eligible for instruction

in a Francophone school if at least one parent is a Canadian citizen and one of the following three conditions exists:

 either parent’s first language learned and still understood is French;

 either parent has received their primary school instruction in Canada in French; or

 one or more of the parent’s children has received or is receiving primary or secondary instruction in French in Canada.

Does your child have Francophone eligibility?

☐ Yes ☐ No

If yes, and you wish to exercise your right, please contact the Conseil Scolaire FrancoSud at 403-686-6998.

The Alberta Student Records Regulations requires that, if requested, The Calgary Board of Education provide the name,

address, date of birth and gender of Section 23 eligible students to the Francophone School District as well as the name,

address and telephone number of the student’s parent.

Revised January 2020 Research & Strategy Page 3 | 8

Previous School Information

Has the student ever registered in a school in The Calgary Board of Education (CBE)?

☐ Yes ☐ No

If yes, provide:

Name of CBE School:

CBE Student ID Number:

Grade Completed:

Withdrawal Date (MM/DD/YYY):

Has the student attended school elsewhere?

☐ Yes ☐ No

If yes, provide:

Name of the Last School Attended:

Alberta Education ID Number (if applicable):

Grade Completed:

Withdrawal Date (MM/DD/YYY):

Reason for Leaving:

Was the student suspended or expelled?

☐ Yes ☐ No

Address of School:

School Phone:

School Fax:

Student Learning Needs

Has the student ever had an Individual Program / Education Plan (IPP/IEP)?

☐ Yes ☐ No

If yes, what is/are the Alberta Education special education code(s)?

If yes and from outside Alberta, provide the special education code(s) and their description(s).

Has the student ever been in a special education program/class or unique setting in CBE or elsewhere?

☐ Yes ☐ No

If yes, what was the name of the program/class or setting, and if not from CBE, provide a description.

Are there any other unique learning needs (including language needs) we should know in order to support the student’s learning?

Legal Guardians / Parents / Others

If there is more than one Legal Guardian, include the information for each guardian on this form whether the guardians live together or not.

A legal guardian may be a parent or other person who is legally responsible for the well-being of the child and makes important decisions

for the child. Legal guardian is defined in section 1(2) of the Education Act and in the Alberta Government website.

For more information refer to the Relationship and Custody and Guardianship Documents at the end of this document.

Please provide a minimum of TWO emergency contacts.

Revised January 2020 Research & Strategy Page 4 | 8

Legal Guardian

First Name:

Last Name:

Relationship to Student:

Emergency Protection Order:

☐ Yes ☐ No

Emergency Contact:

☐ Yes ☐ No

Contact Order (assign a priority level):

☐ 1

st

☐ 2

nd

☐ 3

rd

☐ 4

th

Legal Guardians Live Together:

☐ Yes ☐ No

Do you need help with interpretation?

☐ Yes ☐ No

Custody:

☐ Sole Custody / Parenting ☐ Shared Custody / Parenting ☐ Delegation of Authority ☐ Decision Making

If a court order is in place, a copy must be provided for the student record. Copy of court order:

☐ Yes ☐ No

If there are no court documents, a brief written summary of the current family status is required:

Email Address:

Lives with Student:

☐ Yes ☐ No

Same Address as Student:

☐ Yes ☐ No

Home Phone:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

–

Mobile Phone:

–

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Work Phone:

–

Ext:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Provide an address if different than the student’s. If the mailing address is the same as the guardian’s home address, write “Same”.

Home Address: Apt / Suite #:

Mailing Address: Apt / Suite #:

Street:

City:

Street:

City:

Province:

Postal Code:

Province:

Postal Code:

Home Community (in Calgary):

Legal Guardian

First Name:

Last Name:

Relationship to Student:

Emergency Protection Order:

☐ Yes ☐ No

Emergency Contact:

☐ Yes ☐ No

Contact Order (assign a priority level):

☐ 1

st

☐ 2

nd

☐ 3

rd

☐ 4

th

Legal Guardians Live Together:

☐ Yes ☐ No

Do you need help with interpretation?

☐ Yes ☐ No

Custody:

☐ Sole Custody / Parenting ☐ Shared Custody / Parenting ☐ Delegation of Authority ☐ Decision Making

If a court order is in place, a copy must be provided for the student record. Copy of court order:

☐ Yes ☐ No

If there are no court documents, a brief written summary of the current family status is required:

Email Address:

Lives with Student:

☐ Yes ☐ No

Same Address as Student:

☐ Yes ☐ No

Home Phone:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

–

Mobile Phone:

–

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Work Phone:

–

Ext:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Provide an address if different than the student’s. If the mailing address is the same as the guardian’s home address, write “Same”.

Home Address: Apt / Suite #:

Mailing Address: Apt / Suite #:

Street:

City:

Street:

City:

Province:

Postal Code:

Province:

Postal Code:

Home Community (in Calgary):

Revised January 2020 Research & Strategy Page 5 | 8

Legal Guardian

First Name:

Last Name:

Relationship to Student:

Emergency Protection Order:

☐ Yes ☐ No

Emergency Contact:

☐ Yes ☐ No

Contact Order (assign a priority level):

☐ 1

st

☐ 2

nd

☐ 3

rd

☐ 4

th

Legal Guardians Live Together:

☐ Yes ☐ No

Do you need help with interpretation?

☐ Yes ☐ No

Custody:

☐ Sole Custody / Parenting ☐ Shared Custody / Parenting ☐ Delegation of Authority ☐ Decision Making

If a court order is in place, a copy must be provided for the student record. Copy of court order:

☐ Yes ☐ No

If there are no court documents, a brief written summary of the current family status is required:

Email Address:

Lives with Student:

☐ Yes ☐ No

Same Address as Student:

☐ Yes ☐ No

Home Phone:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

–

Mobile Phone:

–

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Work Phone:

–

Ext:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Provide an address if different than the student’s. If the mailing address is the same as the guardian’s home address, write “Same”.

Home Address: Apt / Suite #:

Mailing Address: Apt / Suite #:

Street:

City:

Street:

City:

Province:

Postal Code:

Province:

Postal Code:

Home Community (in Calgary):

NOT Legal Guardian (Other)

First Name:

Last Name:

Relationship to Student:

Emergency Contact:

☐ Yes ☐ No

Contact Order (assign a priority level):

☐ 1

st

☐ 2

nd

☐ 3

rd

☐ 4

th

Permission to Pick Up Student from School:

☐ Yes ☐ No

Release of Information Form Attached:

☐ Yes ☐ No

Email Address:

Permission to Receive Mail:

☐ Yes ☐ No

Home Phone:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

–

Mobile Phone:

–

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Work Phone:

–

Ext:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Provide a mailing address if different than the student’s.

Apt / Suite #:

Province:

Street:

Postal Code:

City:

Community (in Calgary):

Revised January 2020 Research & Strategy Page 6 | 8

NOT Legal Guardian (Other)

First Name:

Last Name:

Relationship to Student:

Emergency Contact:

☐ Yes ☐ No

Contact Order (assign a priority level):

☐ 1

st

☐ 2

nd

☐ 3

rd

☐ 4

th

Permission to Pick Up Student from School:

☐ Yes ☐ No

Release of Information Form Attached:

☐ Yes ☐ No

Email Address:

Permission to Receive Mail:

☐ Yes ☐ No

Home Phone:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

–

Mobile Phone:

–

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Work Phone:

–

Ext:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Provide a mailing address if different than the student’s.

Apt / Suite #:

Province:

Street:

Postal Code:

City:

Community (in Calgary):

NOT Legal Guardian (Other)

First Name:

Last Name:

Relationship to Student:

Emergency Contact:

☐ Yes ☐ No

Contact Order (assign a priority level):

☐ 1

st

☐ 2

nd

☐ 3

rd

☐ 4

th

Permission to Pick Up Student from School:

☐ Yes ☐ No

Release of Information Form Attached:

☐ Yes ☐ No

Email Address:

Permission to Receive Mail:

☐ Yes ☐ No

Home Phone:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

–

Mobile Phone:

–

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Work Phone:

–

Ext:

Call Order (preference):

☐ 1 ☐ 2 ☐ 3

Provide a mailing address if different than the student’s.

Apt / Suite #:

Province:

Street:

Postal Code:

City:

Community (in Calgary):

Sibling Information (Optional)

Do you have other children attending CBE schools?

☐ Yes ☐ No If yes, specify below.

Name:

CBE School:

Grade:

Name:

CBE School:

Grade:

Name:

CBE School:

Grade:

Name:

CBE School:

Grade:

Revised January 2020 Research & Strategy Page 7 | 8

Declaration

I, the undersigned, hereby represent that I have the legal authority to register the student identified on this form. I have identified

all legal guardians / parents for the student. I declare the information that I have provided on this form is complete and accurate.

I will immediately notify the school of any changes to the information on this form.

Print Legal Guardian / Parent Name

Signature Legal Guardian / Parent Name

Date of Signature (MM/DD/YYYY)

Freedom of Information and Protection of Privacy

The personal information requested on this form is collected under the authority of Alberta’s Freedom of Information and Protection of

Privacy Act (FOIP), the Education Act and its regulations, and the Canadian Charter of Rights and Freedoms, Section 23. This information

will be used for the maintenance of the student’s record, for a school board’s obligation to provide students with an education program that

meets their needs, to provide a safe and secure school environment and other purposes that relate directly to and are necessary for an

operating program or activity, including program placement, determination of eligibility and/or suitability for provincial or federal funding,

contact and health related information in the event of problems or emergencies. Personal information may also be provided to the Minister

of Education for the purpose of carrying out programs, activities, or policies under their administration (e.g., research, statistical analysis).

This information will be treated in accordance with the privacy protection provisions of the FOIP Act.

If you have any questions about this form please contact the school.

Revised January 2020 Research & Strategy Page 8 | 8

Proof of Age and Legal Name

The original document must be provided to the school. The school will make the copy.

The legal guardian / parent must produce the student’s birth certificate at the time of registration. If a birth certificate is not available, the

principal may accept a:

 passport;

 Canadian citizenship certificate;

 Canadian federal government Permanent Residency Card, Permanent Resident Record or Confirmation of Permanent Residency;

 Canadian federal government Record of Landing;

 Canadian provincial government Notice of a Live Birth;

 Indigenous Status card; or

 court order that states the age and legal name of the child.

Note | Students who are not Canadian citizens must register at the Admissions and Assessment Office located at the Kingsland Centre.

Exception – Students in Shelters

If the legal guardian / parent does not have one of the documents listed above, they will provide a written summary of current family status

until documentation can be provided. If applicable, the legal guardian / parent will provide the Restraining Order (RO) or Emergency

Protection Order (EPO).

Relationship

The following are the options for relationships:

 Agency Representative

 Babysitter

 Cousin

 Custodian

 DLSA - CBE Diversity & Learning Support Advisor

 Family Friend

 Father

 Foster Parent

 Grandparent

 Group Home Case Worker

 Home Stay Parent

 Interpreter

 Legal Guardian

 Mother

 Other

 Outside School Care

 Parent

 Partner

 Physician

 Probation Officer

 Psychologist

 Relative

 Sibling

 Social Worker

 Sponsor

 Spouse

 Stepfather

 Stepmother

 Stepparent

 Stepsibling

 System AP, Global Learning

 Unspecified

Custody and Guardianship Documents

The original custody document must be provided to the school. The school will make the copy.

 Decision Making – legal authority for making day-to-day decisions affecting the child. Similar to joint custody, can be court

ordered. If not addressed in an Order, the guardians usually both have rights and responsibilities for this.

 Delegation of Powers and Duties to a Child Caregiver - implicit sub-allocation of powers and duties by the Director of Child and

Family Services, or their delegate (i.e., the social worker), under the Child, Youth and Family Enhancement Act. Done by the

social worker for a child in protective custody – either Temporary Guardianship Order (TGO) or Permanent Guardianship Order

(PGO).

 Shared Custody / Parenting – more than one guardian may exercise the powers, responsibilities and entitlements of guardianship,

unless the court orders otherwise; shall use best efforts to co-operate with one another in exercising their powers, responsibilities

and entitlements of guardianship. Can be court ordered, or presumed if the parents were married and are now separated but

have not been to court.

 Sole Custody / Parenting – allocation, generally or specifically, of the powers, responsibilities and entitlements of guardianship

exclusive to one individual. Usually court ordered.

Fill Online, Printable, Fillable, Blank Student-Registration-Form Student Registration Form - Dependent Students Form

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Fillable Student-Registration-Form Student Registration Form - Dependent Students

Fill Online, Printable, Fillable, Blank Student-Registration-Form Student Registration Form - Dependent Students Form

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