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British Columbia Canadian International School
BCCIS EAST - Application Form
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A- Student Information
Academic Year:
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2025 / 2026
2026 / 2027
Name:
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First
Middle
Last
Grade Applying to:
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pre k
KG 1
KG 2
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Gender:
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DOB:
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MM slash DD slash YYYY
Passport No.:
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Nationality:
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Religion:
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Country of Birth:
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Language at home:
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B- Current School /Nursery Attended
Name:
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Curriculum:
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Grade:
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C- Previous Schools Attended (Ordered by most recent)
Previous School Name:
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Date Entered:
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Date Left:
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Curriculum:
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Previous School Name:
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Date Entered:
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Date Left:
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Curriculum:
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If the student ever repeated a grade, which grade? If the student ever skipped a grade, which grade?
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D- Transportation
Will the student require bus transportation?
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Yes
No
Home address:
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Home Location:
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E- Parent / Guardian Information
Relationship to Student:
Parent First Guardian
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Parent Second Guardian
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Full Name:
Parent First Guardian Full Name
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Parent Second Guardian Full Name
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Home Telephone No.
First Guardian Home Telephone No.
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Second Guardian Home Telephone No.
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Mobile Phone No.
First Guardian Mobile Phone No.
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Second Guardian Mobile Phone No.
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E-mail
First Parent Email
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Second Parent Email
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Nationality
Parent First Guardian Nationality
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Parent Second Guardian Nationality
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Address
First Guardian Address
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Second Guardian Address
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Occupation
First Guardian Occupation
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Second Guardian Occupation
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Organization
First Guardian Organization
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Second Guardian Organization
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F- Custody:
Custody Parents are:
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Custody:
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G- Siblings
Siblings Details:
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Sibling Name
Sibling Age
Sibling Current School / Nursery
Sibling Current Grade
Add
Remove
H- Emergency Contact (other than guardians)
Emergency Contact Name:
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Emergency Contact Phone No.:
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Relationship to Student:
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I- Medical information
Blood type:
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Surgical History:
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Current Medication:
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Allergies:
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Chronic Diseases:
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Special conditions:
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Other conditions: social, behavioral, and/or emotional
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J- Documents
Student photo
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Max. file size: 64 MB.
Father's Recent photo
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Max. file size: 64 MB.
Mother's Recent photo
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Max. file size: 64 MB.
Student passport
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Max. file size: 64 MB.
Student most recent report card
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Max. file size: 64 MB.
Student birth certificate
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Max. file size: 64 MB.
K- Additional information
Additional information:
Agree to Terms and Conditions
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I certify that all of the information provided are true, complete, and accurate and authorize BCCIS to request additional information from teachers/counselors/expert professionals for verification. Acceptance of the child is dependent upon successful fulfillment of our admission requirements. By accepting an application, the school does not guarantee student admission. I hereby give permission to the school clinic to administer all necessary checkups, first aid non- prescriptive medications and to act in casualties and emergencies including admittance to hospital in case of emergency.
I agree to the terms and conditions.
Name
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