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SPECIAL EDUCATION RE-ENROLLMENT Form Page
IT Support
2022-01-05T20:21:38+00:00
SPECIAL EDUCATION RE-ENROLLMENT
Re-Enrollment opens January 17, 2022.
SPED Re-Enrollment Form
Step
1
of
11
- Introduction
9%
Welcome!
You are about to start the re-enrollment form for the Special Education department for CHEK ABC's distributed learning program. We will guide you through this process step by step.
Please be sure to submit copies of these documents during the enrollment process:
-
Authorization to Share Confidential Information
printed and signed
Please note that if you withdraw your child(ren) prior to September 30th, there will be a $50 withdrawal fee per child.
If you have any questions about completing this form please call us at 250-352-0526 ext.222 or email
admissions@chekabc.ca
.
Today's Date
*
MM slash DD slash YYYY
Parent/Guardian Details
Please enter parent name and contact details.
First Name
*
Last Name
*
Relationship to Student
*
Please Select
Mother
Father
Legal Guardian
Other
Email
*
Primary Phone Number
*
Cell Phone
Landline
Please enter cell phone number
*
Please enter landline phone number
*
Secondary Phone Number
*
Cell Phone
Landline
No Secondary Phone Number
Please enter cell phone number
*
Please enter landline phone number
*
Is The Student Currently Living With Both Parents?
*
Yes
No
Provide Details Of Other Parent
First Name
Last Name
Relationship to Student
Please Select
Mother
Father
Legal Guardian
Other
Are You Currently A Resident Of British Columbia?
Yes
No
If no, please explain
*
Do you plan to travel outside of BC for 6 weeks or longer during the school year?
*
Yes
No
If yes, please explain
*
Please complete the
Ordinarily Resident form
found at the beginning or end of this form and submit it with your other documentation when sending in your application.
Provide Your Home Address
*
Street Address
City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Provide Your Mailing Address
Mailing Address - Please provide the address where school resources such as textbooks and report cards should be mailed to.
The same as Home Address
*
Street Address
City
Please Select
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Society Membership
Would you like to become a member of the Nelson Christian School Society?
*
Yes
No
Thank you for your willingness to support Nelson Christian School Society and to further Christian education across BC! There is a $25.00 fee to become a member of the Nelson Christian School Society. Unless you indicate differently, this will be deducted from your family's school based funds.
The Society Constitution and Bylaws
are attached for your late night reading enjoyment!
Student Details
Please provide student name and contact details.
Legal Name
*
First
Last
Middle Name
Middle
Preferred Name
*
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling your student in:
School Year
*
Please Select
2022 - 2023
Grade
*
Grade
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
Additional Student Information
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
What community services are you currently accessing?
*
Speech Language Pathologist
Occupational Therapist
Behavior Interventionist
Clinical Counselling/Psychologist
Physical Therapist
Other
None at this time
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Emergency Contact Person (other than parent)
*
Name
Email Address
Phone
Relationship to student
Medical Information
Are there any allergies or medical concerns?
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Additional Info
Will you be enrolling a second SPED student?
*
Yes
No
Is second student SPED or Regular Enrollment?
*
SPED
Regular
Student Details
Please provide student name and contact details.
Legal Name
*
First
Last
Middle Name
Middle
Preferred Name
*
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling your student in:
School Year
*
Please Select
2022 - 2023
Grade
*
Please Select
Junior Kindergarten
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
Additional Student Information
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
What community services are you currently accessing?
*
Speech Language Pathologist
Occupational Therapist
Behavior Interventionist
Clinical Counselling/Psychologist
Physical Therapist
Other
None at this time
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
Are there any allergies or medical concerns?
Yes
No
Untited
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Additional Info
Will you be enrolling a third SPED student?
*
Yes
No
Is third student SPED or Regular Enrollment?
*
SPED
Regular
Student Details
Please provide student name and contact details.
Legal Name
*
First
Last
Middle Name
Middle
Preferred Name
*
Preferred First Name
Preferred Last Name
Enrollment Year & Grade
Please select the school year and grade that you are enrolling your student in:
School Year
*
Please Select
2022 - 2023
Grade
*
Please Select
Junior Kindergarten
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
Additional Student Information
Date Of Birth
*
MM slash DD slash YYYY
Gender
*
Please Select
Male
Female
Citizenship
*
Please Select
Canadian
Landed Immigrant
Student Visa
Work Permit
Other
Aboriginal Ancestry
*
Yes
No
Please Select
Inuit
Metis
Non-Status
Status - Off Reserve
Status - On Reserve
Status Card #
Band of Origin
Status Card #
Band of Origin
Band of Residence
What community services are you currently accessing?
*
Speech Language Pathologist
Occupational Therapist
Behavior Interventionist
Clinical Counselling/Psychologist
Physical Therapist
Other
None at this time
Has your child ever been involved in unlawful and/or violent behavior?
*
Yes
No
If yes, please explain
Medical Information
Are there any allergies or medical concerns?
*
Yes
No
If yes, please explain
Provide family doctor's information
Family Doctor's name
Family Doctor's phone/email
Parental Permission
I permit my child's name and photo to be used in school publications (eg. School Pamphlets), both electronic and paper.
*
Yes
No
I permit my child to be included in any media coverage of a school related event.
*
Yes
No
Agreement
I/We are willing to support the school, the decisions of the Principal and the regulations passed by the school board.
*
Yes
No
Please type your full legal name to the above statement. In this instance, typed names suffice as a handwritten signature.
*
Covenant
CHEK ABC Family Covenant
*
At CHEK ABC we believe that a successful home education occurs in partnership between home and school. We want to come along side families in a supportive way as they work towards the academic, personal, and discipleship goals of their child(ren). It is vital that parents play an important role in this partnership. The Family Covenant is an agreement that parents will join us in this process.
Please read the statements below and indicate your commitment to CHEK ABC and the schooling at home program.
1. I fully understand that I am making a commitment to educate my child(ren) at CHEK ABC
2. I will positively represent the school in my community
3. I am committed to supporting the policies of CHEK ABC
4. I will support the teachers and the administration of CHEK ABC
5. Should any concerns arise, I will direct them to the teacher as soon as possible
6. In my role as direct overseer of my child's educational program, I commit to:
- Choose the curriculum, in cooperation with the teacher that meets specific Ministry of Education learning standards
- Acquire resources as approved by the teacher
- Work with the teacher to coordinate a Student Learning Plan (SLP).
- Participate in and facilitate weekly contact between my child(ren) and the teacher and request assistance as needed
- Supervise, encourage and motivate my child(ren) on a day-by-day basis, and ensure that sufficient time is given for school work
- Ensure that my child's work is completed in a timely manner
- Submit work samples for assessment visits with the teacher
- Participate in report card assessment visits with the teacher
7. I acknowledge that the Foundation Skills Assessment is required to be written by students in Grades 4 and 7 and will ensure that my child(ren) participates
8. I am committed to the school policy on responsible stewardship and will return any non-consumable resources to CHEK ABC to be shared with others in the school
9. I am committed to academic integrity and will always ensure that my child(ren) complete their own work and write quizzes and tests without assistance of any kind
10. If I withdraw my child(ren) prior to September 30th, I commit to cover the cost of any materials purchased by CHEK ABC and a per student withdrawal fee of $50.
I have read through each of the above statements and commit to upholding them so long as my family is a part of CHEK ABC.
Please type your full legal name to the above statement. In this instance, typed names suffice as a handwritten signature.
*
Attached Files
Please attach supporting documentation to your application
Please use this space to upload the following document:
-
Authorization to Share Confidential Information
printed and signed
Drop files here or
Select files
Accepted file types: jpg, pdf, docx, doc, Max. file size: 99 MB, Max. files: 20.
Tuition
For the 2022-2023 school year, there is a non-refundable tuition fee of $65 per student to enroll in our SPED program.
Please see payment options below.
Payment Options
Credit Card
e-Transfer: email
accounting@chekabc.ca
password: school
Cheque: addressed and mailed to: Nelson Christian School Society 810 Tenth Street, Nelson, B.C. V1L 3C7
Please enter full amount
SPED Re-Enrollment Tuition
Price:
$ 65.00 CAD
Quantity:
Total
$ 0.00 CAD
Credit Card
Card Details
Cardholder Name
Final Step
Enrollment will be finalized when:
- All documentation has been received
- Tuition has been paid
- Administration has accepted placement
This is the final step in the online enrollment process. Please ensure that you have filled out the information accurately, and submitted all necessary documentation. We will contact you to confirm enrollment.
If you are not able to upload any documents at this time you can email a copy of them to
admissions@chekabc.ca
or fax them to us at (250) 352-0546.
Email
This field is for validation purposes and should be left unchanged.
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