Fillable VSB Summer Learning Registration Pre-Approval Application Form (Camosun College)

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VSB Summer Learning Registration Pre-Approval Application Form (Camosun College)

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SS Pre-Approval Form v.1.1 (2022-04-21)
VSB Summer Learning Registration Pre-Approval Application Form
(For students NOT currently attending a VSB school)
• Pre-approval is required for all students who are not currently attending a VSB school.
• Please complete the application form and scan (or provide an image of) the required documents below.
• Pre-approval documentation will be accepted via email or in-person from May 2 to May 27, 2022.
o Email submission: send ONE email message with all attachments (completed registration form
AND required documentation) to summerpreapproval@vsb.bc.ca. Please provide your child’s
Personal Education Number (PEN) in the email subject heading.
o In-person submission: Packages will also be accepted at the Vancouver School District Education
Center from May 2 to May 27, 2022.
• Online registration for approved non-VSB students will begin on Tuesday, May 17, 2022, at 8:00 AM.
REQUIRED DOCUMENTS:
✓ STATUS IN CANADA required from the Custodial Parent or Legal Guardian and Child:
CUSTODIAL PARENT OR LEGAL GUARDIAN:
One of:
Canadian Birth Certificate
Canadian Passport
Canadian Citizenship Card
Permanent Resident Card (front and back)
Status Indian documentation
Nexus Card with citizen listed as CAN (Canadian)
Confirmation of Landed Immigrant or Permanent
Residence (8-1/2 x 14” sheet)
CHILD:
One of:
Canadian Birth Certificate
Canadian Passport
Canadian Citizenship Card
Permanent Resident Card (front and back)
Status Indian documentation
Confirmation of Landed Immigrant or Permanent
Residence (8-1/2 x 14” sheet)
✓ RESIDENCY required from the Custodial Parent or Legal Guardian
One of:
Long-term Tenancy Agreement - showing name and address
Property Purchase Agreement - showing name and address
Property Tax Statement - showing name and address
Income Tax Statement - showing name and province of
residency
And One of:
Utility bill
BC Driver’s License or Enhanced BC Driver’s License
BC ID
BC Vehicle Registration
Canadian bank account statement - showing name and
address
Canadian credit card statement - showing name and
address
✓ GUARDIANSHIP required from the Custodial Parent or Legal Guardian:
One of:
Paper Birth Certificate - parents are named
Income Tax statement - children are declared
Parent’s Confirmation of Permanent Residency or Record of
Landing or valid Immigration Canada documents - children
named on document
If parents live separately, court order or written agreement
granting care to accompanying parent
If not the parent, the legal guardianship must be by will in
accordance with the Infants Act or by a court order in
accordance with the Family Law Act in British Columbia
Child in Care
✓ OTHER RECORDS required:
Most recent school Report Card – showing student’s name and
Personal Education Number (PEN)
Individual Education Plan (if applicable)
SS Pre-Approval Form v.1.1 (2022-04-21)
VSB Summer Learning Registration Pre-Approval Application Form
(For students NOT currently attending a VSB school)
STUDENT INFORMATION
Legal Last Name:
Usual Last Name:
Legal First Name:
Usual First Name:
Legal Middle Name:
Usual Middle Name:
Gender Assigned at Birth:
Female Male
Gender Identity:
Female Male Other
Date of Birth (dd-mmm-yyyy):
Indigenous Ancestry:
Yes No
Citizenship:
Is the student a Study Permit Holder?
Yes No
If yes, what is the Permit Expiry Date?
Home Language:
BC Personal Health Card No.:
Does the student have any Life-Threatening Medical
Condition?
Yes No
If yes, please specify:
Personal Education Number (PEN):
CURRENT SCHOOL
Current School Name:
Current School District:
Current Grade Level:
Does your child receive Education Assistant support
during the regular school year?
Yes No
Does your child have an Individual Education Plan?
Yes No
Does your child currently have a Ministry of
Education Special Education Designation?
Yes No
If yes, please specify:
SS Pre-Approval Form v.1.1 (2022-04-21)
A
DDRESS INFORMATION
Apartment No.: (if applicable)
Street No. and Street Name:
City:
Postal Code:
Mailing Address: (if different)
PARENT/GUARDIAN INFORMATION (Enter one parent/guardian who lives with the student)
Last Name:
First Name:
Primary Phone:
Secondary Phone:
Parent Email:
Confirm Parent Email:
Relationship:
EMERGENCY CONTACT INFORMATION (Enter one emergency contact who can pick up the student in
case of emergency)
Last Name
First Name
Primary Phone
Secondary Phone
Relationship
PARENT/GUARDIAN ACKNOWLEDGEMENT
The information on this form is collected under the authority of the School Act, Sections 13 and 79. The
information provided will be used for educational programs and administrative purposes, and when required, may
be provided to health services, social services or support services as outlined in Section 79 (2) of the School Act.
The information collected on this form will be protected consistent with the Freedom of Information and
Protection of Privacy Act.
I certify that the above information is correct and valid as of this date. I understand that the provision of
false information may lead to my child no longer being enrolled in the Vancouver School District Summer
Learning Program.
Parent/Guardian Signature: Date:
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VSB Summer Learning Registration Pre-Approval Application Form (Camosun College)

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Completed 1 May 2022

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