Pre-Primary Transfer Request Form

Pre-Primary Transfer Request Form
Student Information Student First Name:

Student Middle Name:
 Enter N/A if the child has no middle name.
Student Last Name:

Gender:


Date of Birth:
/ /

1st Parent / Guardian Information First Name:

Last Name:

Primary Phone:

Secondary Phone:

E-mail Address:

2nd Parent / Guardian Information First Name:

Last Name:

Primary Phone:

Secondary Phone:

E-mail Address:

Mailing Address Street, Appartment / Suite:

City:

Province:

Postal Code:

Only children who reside in NS can register for Pre-Primary

Civic Address (if different from mailing address) Street, Appartment / Suite:

City:

Province:

Only children who reside in NS can register for Pre-Primary

School School Presently Attending:

School to Which Transfer is Requested:

Reason For Transfer Request:

If other please specify:

Start Date of Requested Transfer:
/ /


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