NAZ registration form
1
Registration Form - NEW Students Please note that ALL NEW applications must be handed in with the following: Copy of birth certificate Last report card Recent passport size pictures Psychological evaluations if applicable Copy of immunization card) Student Name: (First, Middle, Last)______________________________________________ Age Upon Entering:_______ Date of Birth: (Day, Month, Year)__________________________________ M F Name of Last School Attended: _________________________________________________________________________ Telephone Number: __________________________________________________________________________________ Name of Principal: ___________________________________________________________________________________ Reason(s) for Leaving: _______________________________________________________________________________ _________________________________________________________________________________________________ Has student been expelled, dismissed, suspended or refused admission to any school? Y N If yes, please explain: ________________________________________________________________________________ _________________________________________________________________________________________________ Has student ever had disciplinary difficulties? Y N If yes, please explain: ________________________________________________________________________________ _________________________________________________________________________________________________ Does student have any know learning disabilities? Y N If yes, please explain: ________________________________________________________________________________ _________________________________________________________________________________________________ NAZ Childrenʼs Centre admits students of any race, disability, national or ethnic origin, to all the rights, privileges, programs and activities generally accorded or made available to students at the centre.
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NAZ registration form
Transcript of NAZ registration form
Registration Form - NEW Students Please note that ALL NEW applications must be handed in with the following:
Copy of birth certificate Last report card Recent passport size pictures Psychological evaluations if applicable Copy of immunization card)
Student Name: (First, Middle, Last)______________________________________________ Age Upon Entering: _______ Date of Birth: (Day, Month, Year)__________________________________ M F Name of Last School Attended: _________________________________________________________________________ Telephone Number: __________________________________________________________________________________ Name of Principal: ___________________________________________________________________________________ Reason(s) for Leaving: _______________________________________________________________________________ _________________________________________________________________________________________________ Has student been expelled, dismissed, suspended or refused admission to any school? Y N If yes, please explain: ________________________________________________________________________________ _________________________________________________________________________________________________ Has student ever had disciplinary difficulties? Y N If yes, please explain: ________________________________________________________________________________ _________________________________________________________________________________________________ Does student have any know learning disabilities? Y N If yes, please explain: ________________________________________________________________________________ _________________________________________________________________________________________________ NAZ Childrenʼs Centre admits students of any race, disability, national or ethnic origin, to all the rights, privileges, programs and activities generally accorded or made available to students at the centre.
