604-498-3233 | info@surreychristian.com | www.surreychristian.com

INTERNATIONAL STUDENT APPLICATION

Today's date * +

Student's start date at Surrey Christian School should they be accepted. * +

Requested grade *

Why are you considering our school? *

How did you hear about our school?

Is there someone we can thank for referring you to our school? If yes, please provide their name and contact information.

STUDENT DETAILS

Student legal first name *

Student middle name

Student surname *

Preferred English name

Child's birthdate * +

Gender *

Male

Female

Name of last school attended *

Nationality *

Language spoken at home *

Country of birth *

HOUSEHOLD INFORMATION

Mother first name *

Mother surname *

Mother email address *

Mother's cell phone number *

Mother birthdate * +

Mother occupation

Mother employer

Father first name

Father surname

Father email address

Father cell phone number

Father birthdate +

Father occupation

Father employer

Mailing address in home country

Address line 1

Address line 2

City

State/Province/Region

Zip/Postal code

Country

STUDENT RESIDENCE WHILE ATTENDING SCHOOL

The student will live with *

If the student will be living with a primary caregiver other than a direct parent while attending school, please provide contact information below.

First name of primary caregiver

Surname of primary caregiver

Email address or primary caregiver

Phone number of primary caregiver

Street address of student while attending school

City

Postal code

STUDENT PROFILE

Does the parent or homeschool family attend a church? *

Yes

No

If yes, please provide the name of the church

Does your child have an Individualized Education Plan (IEP), Learning Plan or Behaviour Plan? If yes please attach a copy on the next page under Attachments. *

No

Yes

Has your child been involved with Learning Assistance or Enrichment? If yes, in what areas? *

No

Yes Yes

How many days of school did your child miss last year? Explain. *

Has your child ever repeated a grade, been retained, or been suspended? If yes, please explain. *

No

Yes Yes

What are your hopes and dreams for your son/daughter?

What are your child’s strengths? Please speak to academics, social as well as adjusting to new situations.

What are your child’s challenges? Please speak to academics, social as well as adjusting to new situations.

What are your child’s passions?

Describe your child’s personality?

Describe your child’s learning experience to date.

HEALTH

BC Personal Health Number if student has one

Name of local family doctor if applicable

Doctor phone number

Please check below if your child has any conditions that may require emergency medical treatment. We will require you to complete a medical release form from the school office so that we may add a medical alert to your child’s Permanent Record card.

Diabetes

Epilepsy

Anaphylaxis

Other Other

Does your child have an Epi-pen? *

No

Yes

If your child has an Epi-pen, please complete the Anaphylaxis Emergency Plan form. This can be done after acceptance.

Does your child regularly take medication on a long-term basis? If yes please indicate the name, dosage, and reason (medical condition) for taking the medication *

No

Yes Yes

If your child takes medication regularly on a long-term basis you will need to complete this “Medical Condition/Medication Authorization Form." This can be done after acceptance.

Does your child have asthma? *

No

Yes Yes

If yes, does your child require an inhaler?

No

Yes Yes

Please specify any known allergies or medical conditions of which we should be aware.

Please check any of the following services that your child may have received. If any, please attach a copy of pertaining reports on the next page under Attachments.

What other medical information would help us better understand your child? (Allergies, hearing impairment, vision, development.)

EMERGENCY CONTACTS

In the event of an emergency and we cannot reach a parent, please provide name and contact information of someone who has authorization to pick up your child.

First and last name of emergency contact/person allowed to pick up your child.

Relationship to student

Comments

Phone number

First and last name of a second emergency contact/person allowed to pick up your child.

Relationship to student

Phone number

CONSENTS

Field Trip Consent

Acknowledgement of Risk

I have read the school's Acknowledgement of Risk form (link above) and consent to having my child participate in low risk day trips. *

Yes

No

Photograph Publishing Consent

Throughout the school year photographs are taken of various student activities. I consent to have the student’s picture published in the school newsletter, publications or on our website. The school only publishes first names of students. *

Yes

No

Protecting Your Personal Information

Surrey Christian School collects and uses personal information for the sole purpose of maintaining accurate student records in the administrative offices, and to respond immediately to an emergency. SCS commits to using and storing this information responsibly and will not release this information to a third party without your verbal or written consent unless permitted under the PIPA (Personal Information Privacy Act) legislation. If you have questions about SCS’s use, storage or disclosure of personal information, please contact our privacy officer. I consent to having SCS collect, use and disclose this personal information as outlined above. *

Yes

I consent to the school office providing my email and phone number to other classroom parents for the purposes of play dates, birthday party invitations etc. *

Yes

No

FEES

FEES

Application Fee (non-refundable) due with application — $400.00. Pay online here

Tuition Fee — $20,000 (Kindergarten to grade 2); $20,580 (grade 3-12). Includes BC MSP medical coverage, ELL support, and international coordinator support services

Activity Fees for grade 8-12 only — $500. Does not include overnight trips

Settlement Services — $1,500
- Provide custodian letter
- Screening and selection of homestay family
- Communication with parents before and upon arrival
- Purchase medical insurance
- Assistance in purchase of cell phone & phone card
- Assist in finding medical clinics and community services
- Initial homestay visit by the homestay coordinator followed by quarterly reviews
- Communication with parents in native language re: student's quarterly progress
- Continuous review of student's adjustment and homestay living condition
- Special Canadian birthday celebration for the student
- Special invitation letters for the parents visit to Canada

Homestay Fees — $13,000 (September-June), includes school bus transportation if required.

Extended Health Coverage (dental, travel, prescription drugs etc.) — $800

PAYMENT OPTIONS include cheque, bank draft or wire transfer.

REFUND POLICY

In the event that a student authorization cannot be obtained, or the student decides not to attend or withdraws from the school, or if a student is asked to leave due to undisclosed and profound behaviour or learning needs, the following refund policy will apply:

Full refund of fees will be given only if the student visa is not approved. An original copy of rejection letter from the embassy is required. If the student withdraws, or if a student is asked to leave due to undisclosed and profound behaviour or learning needs, within 30 days of the start of class, 50% of the tuition fee is refundable. No refunds if the student withdraws or is asked to leave due to undisclosed and profound behaviour or learning needs, 30 days or more after the start of class.

SCHOOL BUS

BUS FEES AND REGISTRATION

Our school provides school bus service when and where possible. The bus system is operated by a separate organization which aims to accommodate all requests from families for bus service. However, we cannot guarantee that a school bus will be available in your area on a route that meets your needs. Your child may need to be driven to a stop closest to your home on an existing route.

The student will require school bus transportation *

Yes

No

I don't know

If yes

Return trip (morning and afternoon)

1-way mornings

1-way afternoons

I understand and acknowledge that the school must receive notice of school bus cancellation by Sept. 30. After Sept. 30 I will be charged for the full year regardless of whether we are using the service. (If your child is not registered to take the bus please click Yes anyway to indicate you understand the policy should you decide to use bus service later.)* *

Yes

Click here to view the school bus fees for the 2023-24 school year.

PARENT COMMITMENT

I understand and agree with the mission, vision and core values of the school and indicate that I enroll my child because of my desire that my child receives a Christ-centered education. *

Yes

If my child is accepted by the school, I agree to support the policies of the school board and will submit to the authority invested by the board in the superintendent, principals and classroom teachers. *

Yes

I agree to attend the “New Parent Orientation” session and other pertinent meetings and events. *

Yes

I agree to provide a healthy study environment at home and understand that the Canadian school system expects students to receive 7-8 hours of sleep at night. *

Yes

I understand that the school reserves the right to dismiss any student who does not respect the standards of the school as outlined in the Student Handbook or co-operate in the educational process. *

Yes

I agree to submit the following fees within two weeks after the time of acceptance: Tuition, Settlement Services, Activity Fees (grades 8-12). *

Yes

I understand and acknowledge that the school must receive notice of school bus cancellation by Sept. 30. After Sept. 30 I will be charged for the full year regardless of whether we are using the service. *

Yes

I am aware of the computer and internet usage guidelines for students at the grade 7-12 level and understand that my child’s violation of these guidelines will be cause for removing his/her internet usage privileges and may result in disciplinary action. The guidelines can be found on page 29 in the Student Handbook posted on our website at the bottom of our Admissions page. *

Yes

I will inform the school if my child’s address changes during the school year, or if their guardian or homestay information changes. *

Yes

Kindergarten	Grade 1	Grade 2
Grade 3	Grade 4	Grade 5
Grade 6	Grade 7	Grade 8
Grade 9	Grade 10	Grade 11
Grade 12

Both parents together	Mother
Father	Guardian
Homestay	Relative
Other Other