Form 527-2

Form 527-2
FORM F527-2
Adopted
—
Last Revised
March , 2013
Review Date
June 15, 2015
REQUEST FOR ADMISSION TO HASTINGS AND PRINCE EDWARD DISTRICT SCHOOL BOARD
Birth Date (month/day/year)
STUDENT INFORMATION
Full Name
Telephone
Address (street, 911, mailbox # if applicable)
Province
City/Town
School to Attend
Postal Code
Grade
Starting Date
Last School Attended
Address
Individual Education Plan
Yes
No
If yes, describe exceptionality:
APPROVAL
SIGNATURE
RESIDENT STATUS
PARENT/GUARDIAN INFORMATION
If yes, signature of Superintendent of Special Education is required:
Please note: If the applicant is not the student’s parent, documentary evidence of lawful custody must be produced for examination by the principal.
Full Name
(Complete address section only if different from above.)
Address (street, 911, mailbox # if applicable)
City/Town
Telephone
Province
Postal Code
Reason for this Request
Transportation: If residing outside of Hastings County and Prince Edward County, transportation is the responsibility of the parent.
Ontario Residents
No fees are applicable but the principal’s approval is required indicating that programming and accommodation are
available.
Ontario Residents living
on tax exempt land
Fees may be applicable. Please contact Business Services.
Residents outside
Ontario
Fees may be applicable. Please contact Business Services.
Signature of Parent/Legal Guardian
Date
Signature of Principal
Date
Signature of Superintendent of
Education
Date
Signature of Superintendent of
Business Services
Date
Personal information contained on this form is collected under the authority of the Education Act and in accordance with the Municipal Freedom of Information and
Protection of Privacy Act. It will be used to determine eligibility of the student to attend a Hastings and Prince Edward District School Board school and to determine fee
requirements. Questions about this form can be directed to the Superintendent of Business Services at 613-966-1170 or 1-800-267-4350.
This form is for the current year only and will be reviewed annually. The completed form can be forwarded directly to the school or to the Education Centre,
156 Ann Street, Belleville, Ontario, K8N 3L3, Attention Business Services.
March 2013
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