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L’école Rocher-du-Nord
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X
Rechercher
Rechercher
Découvrez l’école
L’école Rocher-du-Nord
Notre équipe
Conseil d’école
Communications
Calendrier/Horaire
Parascolaire
Organismes communautaires francophones
Documentation
Liste de matériel scolaire
Code de vie
Plan de développement et rapports annuels
Contactez-nous
Programmes/Services
Programmes scolaires
Services aux élèves
Culture et sport
Transport scolaire
Autres services
Admission
Carrières et emplois
X
STUDENT INFORMATION FORM
STUDENT INFORMATION
Name :
*
Given name
Last name
*
F (female/girl/woman)
M (male/boy/man)
X (non-binary person or another gender identity)
NS (not specified/prefer not to say)
Date of birth :
*
MM slash JJ slash AAAA
Place of birth :
*
Main address :
*
Other address if shared custody :
MCP card number :
*
Expiration date :
*
Grade this year :
*
Brothers or sisters at school ?
*
Yes
No
Informations on sister(s) or brother(s)
Last name, Given name(s) :
Grade :
School attended last year : (Name, School Board, City)
Hidden
First language spoken at home:
*
Second language spoken at home:
MEDICAL INFORMATION
ALLERGIES?
*
YES
NO
Allergies
Allergy :
*
Symptoms :
*
Instructions in case of an allergic reaction :
*
Medication(s) :
*
Does your child have anaphylaxis?
*
Yes
No
Please have the document
Anaphylaxis Alert Life Threatening Allergies
filled by a doctor and submit it to the school.
Asthma :
*
Yes
No
Symptoms :
*
Instructions in case of asthma :
*
Medication(s) :
*
Hidden
DOES YOUR CHILD HAVE OTHER MEDICAL CONDITIONS?
*
Yes
No
Condition(s) :
*
Symptoms :
*
Medication(s), if applicable :
OTHER USEFUL INFORMATION
Please provide details about any other condition or information of which the school should be aware :
PARENT OR GUARDIAN INFORMATION
Parent/guardian 1
Family name, Given Name :
*
Phone (cell)
*
Phone (home)
Phone (work)
E-mail
*
Parent/guardian 2
Family name, Given Name :
*
Phone (cell)
*
Phone (home)
Phone (work)
E-mail
*
SUBMISSION OF THE FORM
Submission of the form acts as a signature to the document. For any questions, please contact us at the following email: ecole-rdn@csfptnl.ca
Date :
*
MM slash JJ slash AAAA
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