Meadowland
s Canadian
School
Student Registration Form
1. Student Registration
Legal First Name
Legal Last or Family Name
Preferred First Name or English Name
Student’s E-Mail Address
Student’s Mobile Phone Number
Date of Birth (yyyy-mm-dd)
Gender
Citizenship
Country of Citizenship
Country of Birth
First Language Spoken English
2. Student’s Home Address
House Number
Street Name
Unit #
City/Town
Postal Code
Province/State Abuja, FCT
Country Nigeria
Page 1 of 4
3. Previous School Information
Have You Ever Attended an Ontario No
School?
OEN (Optional)
Current School Name or Last
Attending School Name
Type of Curriculum of Previous School
First Date of Grade 9 (yyyy-mm-dd)
Last Completed Grade
4. Parent/Guardian Information
Parent/Guardian First Name
Parent/Guardian Last/Family Name
Relationship to Student
Parent/Guardian Email Address
Parent/Guardian Mobile Phone
Number (s)
5. Registering Program
Student expected Start Date
Registering for Grade
Field of Study Interest
Total No of courses student will take
with Rosedale
Page 2 of 4
6. Parent/Student Consent
Please read the statements below and tick the checkbox to agree (Students’ consent
when the student is 18 years of age or older. Parent/Guardian’s consent when the
student is 17 years of age or younger):
I understand that Rosedale Academy collects personal information pursuant to
the Education Act, the Ontario Educational Communications Authority Act and
their respective regulations. I understand that the information collected will be
used to establish and maintain a Student Record for the purposes of providing
educational services to the student. This information may also be used for
statistical purposes.
YES, I understand and agree to the statement above
x
Photograph/Media Consent: I hereby provide consent to Rosedale Academy to
photograph,
video/audio tape or interview my child and to post any personal information
herein contained on school
websites, social medial accounts or in promotional materials/advertisements. I
understand that
personal information posted on the sites could be copied, altered or moved to
another site by anyone
who visits these sites.
YES, I consent for my child to be photographed, video-taped, audio-taped or
x interviewed
x I understand that a copy of government-issued photo ID and official transcript
must be promptly submitted to Rosedale Academy for student registration and
enrollment, and agree to be contacted by an administrator during the process.
By submitting this document, I agree to register with Rosedale Academy, and
x
understand that I will obey all Rosedale Academy’s online-use policies as well as
all academic policies and regulations.
PLEASE NOTE THAT WE SEND FEES PAID TO ROSEDALE AND THEREFORE ARE NON-
REFUNDABLE. ALSO, ONCE A CHILD IS REGISTERED, ROSEDALE COLLECTS ALL FEES. IT IS
THEREFORE MANDATORY FOR PARENTS TO PAY FULL FEES EVEN IF THE CHILD
WITHDRAWS.
Applicant’s Signature:
Parent/Guardian’s Signature:
Page 3 of 4
Date of Application:
Page 4 of 4
