Newbridge Academy - Application Form
Applicants Name*
Anticipated Grade of Entry
Anticipated Enrollment Year*
Please note: we do in-year enrollment as well
Gender*


File Upload - Upload and Attach their Report Card
Please provide latest report card
Date of Birth*

School(s) previously attended within the last three years: *
How did you hear about Newbridge Academy?*
Applicants Parent / Guardian*

First Name

Last Name
(Required)
Phone Number*
Cell Phone Number
Email*
(Required)
Address*

Address 1


Address 2

Country

City

State

Zip Code
Current Grade Level*
Current School*
Has this student ever repeated a grade in school?*


If yes, please explain:
Has this student ever been suspended, expelled, or refused admission at another school?*


If yes, please explain:
Please provide an academic reference:
Academic Reference Name:
Academic Reference Phone:
Academic Reference Email:
Academic Reference School:
Applicants Other Parent / Guardian*
Applicants Other Parent / Guardian - Phone Number
Applicants Other Parent / Guardian - Cell Phone Numger
Applicants Other Parent / Guardian - Email Address
Applicant Lives With:*
Choose if Applicable:
If parents do not live together, please specify to whom the following should be sent. Check the appropriate boxes:
General Correspondence:*
School Reports: *
Financial Statements/Invoices:*
People not authorized to pick child up from Newbridge Academy: *
(Please note that in order to enforce any custody orders, the school must be provided with court documentation and any other legal arrangements)
Are there any Psychological Education Evaluations, Adaptations, Individual Program Plans (IPP’s), or other documents that would help us understand the learning style and needs of the student?
*


If yes, please explain:*
Please indicate special interests, activities, awards, favourite books:*
Please detail all of your children (both Newbridge and non-Newbridge students)
Sibling Name / Date of Birth:
Sibling Name / Date of Birth:
Sibling Name / Date of Birth:
Student Health Card #:*
Student Health Card Expiry:*
Family Physician:*
Physician Phone Number:*
Medical History:
Previous surgery and serious illness (with dates):*
Fractures sustained (with dates):*
Drug allergies:*
Other allergies:*
Regular medication:*
Does the student require regular injections?*
Family medical history to be aware of?*
Psychiatric/emotional wellness history?*
Does the student wear glasses or contacts?*
Student Weight: *
Student Height:*
Is there any reason why this student should not be able to participate in the school sports programming?*
Describe Your Child in 250 Words or Less:*
Emergency Contact Information - These should be different than parent or guardian information provided.
Emergency Contact Name:*
Emergency Contact Home Address:*
Emergency Contact Postal Code: *
Emergency Contact Phone 1:*
Emergency Contact Phone 2:
Emergency Contact Email:*
Do you intend to apply for financial aid?*


Program Selection:*









Current Sports Team(s) if any*
Years of Experience*
Please send $50 application fee via e-transfer to angela@newbridgeacademy.ca
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