Holy Cross Regional Secondary New Student Application Form 2024/2025

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

16193 88th Avenue
Surrey, BC
V4N 1G3
Phone: 604-581-3023
Fax: 604-583-4795

*Please be advised that applying to Holy Cross Regional Secondary, does not determine acceptance. Please refer to our brochure for Holy Cross' information including acceptance policy and tuition rates here.

Email *

Student's Last Name *

Student's First Name *

Student's Middle Name

Student Gender *

MALE

FEMALE

Student's Birthdate *

YYYY

Grade (September 2024) *

Grade 8

Grade 9

Grade 10

Grade 11

Grade 12

Citizenship Information for Student *

Canadian

Permanent Resident

International Student/Student Visa

Parent Information

Father's full name (first and last)

Parent Information

Mother's Full name (first and last)

Legal Guardian Information

Legan Guardian (first and last)

Citizenship Information(Father)

Canadian Citizen

Permanent Resident

Lawfully admitted to Canada under one of the following documents(please choose appropriate box below)

Admission as a refugee claimant

Valid student authorization (student visa) for two or more years

Valid employment authorization (working permit) for two years or more

A person carrying out official duties under the authority of the Visiting Forces Act or as an accredited diplomatic agent, pre-clearance officer, consular office or official representative in Canada of a foreign government with a consular post in British Columbia

Other

Clear selection

Citizenship Information(Mother)

Canadian Citizen

Permanent Resident

Lawfully admitted to Canada under one of the following documents(please choose the appropriate box below)

Admission as a refugee claimant

Valid student authorization (student visa) for two or more years

Valid employment authorization (working permit) for two or more years

Other

Clear selection

Citizenship Information(Legal Guardian)

Canadian Citizen

Permanent Resident

Lawfully admitted to Canada under one of the following documents(please choose the appropriate box below)

Admission as a refugee claimant

Valid student authorization (student visa) for two or more years

Valid employment authorization (working permit) for two or more years

Other

Clear selection

History of Academic Support

If your child has received Learning Support at school in the last two years, please answer the questions below.

Has your child received Learning Support at school in the last two years? (Please check one of the boxes. If No, please proceed to the next section of the application. If yes, please continue to questions below).

Yes

Does your child currently have an Individual Education Plan (IEP) in place, at school, in the last two years?

Yes

Clear selection

Does your child have a Ministry of Education Designation assigned to their IEP or learning profile?

Yes

Clear selection

If yes to the above question, please identify the Ministry of Education Special Education Designation that applies to your child.

Category A: Physically Dependent Student

Category B: Deaf and/or blind

Category C: Moderate to profound Intellectual Disability

Category D: Physical Disability/Chronic Health Impairment

Category E: Visual Impairment

Category F: Deaf or Hard of Hearing

Category G: Autism Spectrum Disorder

Category H: Student Requiring Intensive Behaviour Intervention

Category K: Mild Intellectual Disability

Category P: Gifted

Category Q: General Learning Disability

Category R: Student Requiring Behavioural Support

My child does not have Ministry of Education Special Education Designation.

Clear selection

Has your child received any professional services in or outside of school in the last two years? ( Please check all that apply)

Speech Language Pathologist

Behaviour Interventionist

Behaviour Consultant

Occupational Therapy

Psychologist or Psychiatric Services

Counselling

Teacher of the Deaf and Hard of Hearing

Current Address (house number and street) *

City and Province *

Postal Code *

Phone Number *

Cell Number

Religion *

Catholic

Other

Name of Parish in which family is registered

Please choose below:

Immaculate Conception Parish, Delta

St. Joseph's Parish, Langley

St. Nicholas Parish, Langley

Star of the Sea/Good Shepherd Parish/White Rock/South Surrey

Our Lady of Good Counsel Parish, Surrey

Precious Blood Parish, Surrey

St. Andrew Kim, Surrey

St. Bernadette Parish, Surrey

St. Matthew's Parish, Surrey

Clear selection

Catholic parish outside Holy Cross' Region

Please fill in Parish and City

Other Denomination

If you selected "Other" above - please share your family's' religious affiliation

Sibling Information

Brother(s) or sister(s) attending Holy Cross (please list name and grade below)

Present School *

List the school where your child currently attends

Is Holy Cross Regional Secondary your first choice *

yes

If Holy Cross Regional Secondary is not your first choice, please list your first choice

How did you hear about our school?

family friend

parish

other

Clear selection

I hereby certifiy the preceding information to be complete and correct *

yes

Consent *

I consent to having Holy Cross Regional Secondary collect personal information that includes student birthdate, gender, address information, citizenship information, parent information including citizenship, contact information, sibling information, school presently attending, Religious information and any similar information needed for this application. Holy Cross Regional Secondary will take all measures to safely secure all electronic and hard copy of information.

yes

Consent for families from Catholic parishes:

I consent to having my family's name included in a family list that will be shared with my pastor in order for the school to make an informed decision about acceptance to Holy Cross.

yes

Clear selection

Date *

Please fill in the date document was completed.

YYYY

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Holy Cross Regional High School. Report Abuse

Forms