Student Admission | .

Student Admission

Note: * indicates required field

Admission Form for School: Jaya International High School

Given Name *

Last Name *

Middle Name(s)
(if applicable)

Preferred Name
(if applicable)

Gender *

Date of Birth *

First Language

Grade *

MIN/OEN

Status in Canada

Province Of Permanent Residence

Year of Entry to Canada
(if applicable)

Address *

Phone *

Student Mobile #

Parent/Guardian Mobile #

Student Email *
(must be unique)

Student Password

Mother's Name

Mother's Business Phone

Mother's Home Phone

Father's Name

Father's Business Phone

Father's Home Phone

Guardian's Name

Guardian's Business Phone

Guardian's Home Phone

Custody Status

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Business Phone

Emergency Contact Home Phone

Parent/Guardian Email

Parent/Guardian Password

Student #

French Admission

Attendance Type

Source of Verification

Comments

Photo

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Additional Document
(Where Applicable)

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