Student Full-Application Form

Student Application Form

Student Information
Tuition
Code of Conduct
Residency Form
Medical Release Form
Release of Information
Parent Agreement

Form A - Student Application

APPLICATION DOCUMENTS REQUIRED | Parent Checklist

Copy of Student’s Birth Certificate
Proof of Current Address:
- (BCID, BC Driver’s License, Utility Bill, Rental Agreement, Mortgage Document)
Copy of Student’s valid Canadian documents: (if born outside Canada or new to Canada)
- (Permanent Resident Card, Canadian Citizenship Card, Canadian Passport, Student visa)
Copy of Parent’s valid Canadian documents: (if born outside Canada or new to Canada)
- (Canadian Passport, Permanent Resident Card, Canadian Citizenship Card, Student visa, Work permit, Refugee documentation)
Most Recent Report Card
Student Medical Release Form

ADDITIONAL DOCUMENTS IF APPLICABLE

Immunization Records
Specialized Learning Plan Documents: IEP,
Diagnosis, Assessments, ELL, etc
Medical Safety Plan,
Request For Administration of Medication,
Anaphylaxis Safety Plan
Dr. Note

STUDENT INFORMATION

Date of Application

First Name

Middle Name

Last Name

Date of Birth

Gender

Male

Female

Birth Certificate

File Upload

Does your child have an up to date Immunization record?

Yes

I don't wish to have my child immunized

If you do have a copy of the immunization record, please upload a copy.

File Upload

Is the child Immunized ?

Yes

Start Date Requested

Student is Entering Grade:

To register for Kindergarten your child must turn 5 years of age on or before December 31 of the coming school year.

Please upload a copy of the student's latest report card if available

File Upload

Primary Guardian Info and Home Address of Student

Primary Guardian 1

Last Name

First Name

Middle Name

Relationship

Phone Number

E-Mail Address

Primary Guardian 2

Last Name

First Name

Middle Name

Relationship

Phone Number

E-Mail Address

Preferred Teacher/Parent Contact

E-Mail

Phone

Other

Other Contact Method

Legal Address

Full Address

Province

Postal Code

Mailing Address Same as Legal Address ?

Yes

Full Mailing Address

Province

Postal Code

Secondary Parent/Guardianship

Secondary Parent/Guardian

Last Name

First Name

Middle Name

Relationship

Phone Number

E-Mail Address

Secondary Parent/Guardian Address

Full Address

Province

Postal Code

Secondary Parent/Guardian - Other Instructions or Requests

Emergency Contacts - other than parents/guardians (in order of preference).

Emergency Contact

Last Name	First Name	Relationship	Phone Number	Can Pickup Child ?

PREVIOUS SCHOOL INFORMATION

Name of School Student is Currently Attending or Attended Last Year

Current Grade

Has This Student Ever Repeated a Grade?

Yes

Is This Student on an Individual Education Plan (IEP)?

Yes

Was the IEP a Modified program or an Adapted program?

Modified Program

Adapted Program

Other Program

Does the student have a diagnosis? Please explain and upload relevant documents regarding testing and diagnosis, if available.

Please upload a copy of the latest IEP program.

File Upload

Diagnosis/assessment documentation

File Upload

School Contact Numbers

Office Phone

Fax

Name of Principal

Name of Teacher

Please note, Mountain Christian School will be contacting the Previous School for the Student Records

CHURCH DATA

We don't have a church

Church 1

Church Currently Attending

Name of Pastor

Number of Years in Attendance

Church 2 (if previously attending a different church)

Church Name

Pastor Name

Number of Years in Attendance

Not all families at MCS regularly attend church, however; all students enrolled at MCS must participate in weekly chapel services and be respectful and open to learning about the Bible. Parents must play a supportive role in this regardless of their personal beliefs.

PERSONAL INFORMATION AND PRIVACY ACT

Mountain Christian School will only use, disclose and retain personal information for the purpose for which it was collected unless the individual has otherwise consented, or when its use, disclosure or retention is required or permitted by law. Please refer to our student/parent handbook or our website for the complete policy.

POLICIES AND PROCEDURES

Student/Parent handbooks are sent home at the beginning of the year with all students. They are also in our application package.

MCS Policy and Procedure Manual is stored in the school office and may be signed out by school members at any time. Policy revisions will be posted on our website.

Form B - Tuition

POLICIES RELATING TO TUITION AND FEE PAYMENTS

Standard tuition rates apply to all students admitted to the school. The following policies apply unless arrangements have been made with the principal.

All tuition and rates and fees are due at the beginning of each month. Tuition may be paid with postdated cheques, Interac, Visa, MasterCard, or via our Tuition billing platform, TUIO. NOTE: your TUIO account will be set up and billing will commence after your child has been accepted and enrolled.
No children of parents owing overdue tuition or other obligations (vandalized books, equipment) will be remitted into MCS for the following year unless payment arrangements have been made.
If parents are struggling to meet their financial obligation they must meet with the office administrator immediately to arrange a payment plan. It is our policy that we do not turn away families that desire a Christian education for their children because of financial difficulties. An alternative payment plan must be in place for the child to be re-enrolled for the following year.
When a student voluntarily withdraws from the school for any reason, two month’s written notice must be given, or, two month’s payment is due to the school.
When a student is expelled or withdrawn at the recommendation of the school, tuition will be due up the end of the month of expulsion.
The Bethel Board considers that all unpaid tuition accounts from past years are still due to MCS. Careful records are kept and any parent may determine the status of his/her account by inquiring to the school office.

NOTE: Penalty Fees will be added to your account: $35 for a failed / stop payment $25 for non sufficient funds.

Tuition Payment

I am able to pay regular tuition

I may qualify for government assistance program

Parent/Guardian Full Name

Relationship to the child

Signature

Sign Here

Form C - Community Standards & Student Code of Conduct

Students will follow and be held accountable to the expectations as per the student handbook policy. Students entering grades 4-12 will sign the student code of conduct.

At Mountain Christian School we seek, through word and action, to create an environment of trust and mutual support in which each member of our community can grow. There is an emphasis on the need to be sensitive to those we come in contact with so that each student can realize their individual, God-given potential. As a Staff we are committed to the on-going educational process of developing unique persons in a Christ-centered environment where faith is translated into action.

We all must learn to work individually and with others. Mutual respect, cooperation and sharing are important values in any social experience. The ability to work with and for others is an important part of the learning process. In all we do, there must be respect for God and His work, self, other, property and authority. Any overt behavior, which would demonstrate a lack of respect (e.g. cruel teasing, bullying, discourtesy, blasphemous language or vulgarity, stealing, etc.) will be dealt with so that the well-being and security of everyone in the school is ensured.

Students are to live consistent Christian lives wherever they are. Those who are not leading such lives often reflect this in their studies and their attitude toward other students.

Involvements with Tobacco and Vapour products, alcohol and illegal drugs are serious offences and all students are placed under strict obligation to refrain from such use at all times and in all places. A breach of this guideline will normally result in disciplinary action ranging from suspension to expulsion.

I am aware of the school's CODE OF CONDUCT and I AGREE to abide by it and to support it to the best of my ability. As a student attending a Christian school, I pledge to uphold the school's standards against cheating, swearing, smoking, drinking alcohol, gambling, sexual activity, using or talking favorably about narcotics or using indecent language. I further pledge to act in an orderly, kind and respectful manner at all times, striving to be a good character in dress, attitude and conduct.

Parent/Guardian Full Name

Relationship to the child

Signature

Sign Here

Form D - Parental / Guardian Residency Form

To be completed and signed by a parent or legal (court-appointed) guardian.

If you are a legal guardian, please attach a copy of the court order appointing you as the legal guardian. We are required by the BC Ministry of Education to have this information in the student's file in order to confirm parent/guardian residency for funding purposes.

Residency Status

Canadian Citizen

Landed Immigrant / Permanent Resident

Work / Study Permit

Upload a photocopy of PR card or Work/Study permit

File Upload

Residency in British Columbia

I am a Resident of British Columbia

I am not a resident of British Columbia

Resident of B.C., please provide your Postal Code

Please upload Proof of Residency - Driver's LIcense, BC ID, or Utility Bill stating parent(s) name(s) and current BC address.

Choose File

Parent/Guardian Full Name

Relationship to the Child

Signature

Sign Here

Form E - Medical Release Form

This form is used for recording parental permission for medical treatment in case of medical concerns at school or on a field trip.

NOTE: In the event of any medical emergency situation, even with this form, the school will attempt first to contact the students' parent/guardian.

Parental Permission

We, the undersigned as the parents and legal guardians of %first_name% %last_name%, hereby consent to treatments which may be deemed advisable by a physician selected by the teacher in charge.

Parent / Guardian's Full Name

Date

Signature

Sign Here

BC Medical Care Card #

Family Doctor Information

First Name

Last Name

Phone Number

Address:

Please list any Allergies, Food Sensitivities, or any other Special Conditions (e.g. asthma, medication)

My child has a physical, medical condition as noted above If so, please choose one or more of the following options below and submit the required information / documentation

My child REQUIRES a Medical Action Plan (completed & submitted with application)

My child has a severe allergy and REQUIRES an Anaphylaxis Safety Plan (completed & submitted with application)

My child is on Medication and REQUIRES a Request for Admin of Medication Form (completed & submitted with application)

I am providing a Dr. Note regarding my child's condition(s) / diagnosis

Click HERE to submit Medical Action Plan

Click HERE to submit Anaphylaxis Action Plan

Click HERE to submit Admin of Medication Form

Physical, medical condition Supporting Documentation

File Upload

Form F - Release of Information

Release of Information Statement

***Please read the entire form before signing below***

STUDENT RECORDS: All Student Records kept on file are confidential.

Professionals who are planning for, or delivering education, health, social or other support services will have access to student records without consent.

THIS INFORMATION MAY INCLUDE:

All education records and other information related to a child’s ability to perform in school, including but not limited to Physiological, psychiatric or other mental impairments(s); any drug abuse or other substance abuse; copies of all educational tests and evaluations including individualized Education plans or Case Management Plans, speech evaluations, and any other records that may help evaluate function, also teachers’ observations and evaluations.

FROM WHOM: All Physiologists, mental health, psychiatrists, schools, teachers, counselors, social workers, and correctional facilities.
TO WHOM: Mountain Christian School Employees and other internal / external Professionals who are planning for, or delivering education, health, social or other support services.
PURPOSE: For determining a program that best suits the child’s needs, and which may result in enrollment at Mountain Christian School.

By proceeding, I, , acknowledge and agree for the above statement to apply to , born on

Parent / Guardian Full Name

Date

Signature

Sign Here

Form G - Parent Agreement

Parent/Student Handbook Consent

I have read the Parent/Student handbook and fully understand the commitment that I am making.

All documents can be found HERE

Media Publications

I/We give Mountain Christian School permission to use a picture of the child named in this application for normal school operations such as the school yearbook, websites, publications, and bulletins and newsletters.

Field Trip Annual Consent (Low risk trips)

I/We understand that Mountain Christian School arranges for students to participate in field trips, which, in the opinion of the MCS, have definite educational, athletic, or cultural value and are considered in the category of low risk activities. These day trips are very common and happen quite regularly throughout the school year.

This form is not intended to request your approval for field trips that are considered high risk or overnight activities. A separate permission form will be sent home for high risk or overnight field trips.

I/We understand that any medical information requested would be collected for the purpose of student safety during field trips, including student athletic events (which are generally considered to have and inherent element of risk of injury despite all safety precautions).

Low risk Field Trips will be communicated in advance to parents/guardians via email, student agendas, school Facebook page, or newsletters, or through student planning meetings. Parents may advise the school prior to any particular trip that I/We do not consent to the student(s) participating in a particular field trip.

By signing I/We freely and voluntarily assume the risk/hazards inherent in the program/activity and understand and acknowledge that my child may suffer personal injury due to an unforeseeable event associated with his/her participation. I consent that the School, through its employees, may secure such medical advice and services as they deem necessary for my child's health and safety, and that I shall be financially responsible for such advice and services.

Field Trip Annual Consent

Yes

Do you require bussing for your child?

In Town: MCS BUS (includes MCS Transfer Service between both MCS Campuses)

Out of town SD 59 Bus (includes SD 59 Transfer Bus to MCS Alpha Campus)

Please fill the bussing form HERE

How do you wish to pay your registration fee?

Pay at Front Office

Pay upon receiving Invoice

Parent / Guardian Full Name

Date

Signature

Sign Here