Child's Name Date
Child's Birthdate Health Card Number
Present School Grade Applying For
Child's Address Suite/Unit
City/Town Province/State
Postal/Zip Country
Telephone Email Address
Mother's Name Occupation
Home Phone Business Phone
Father's Name Occupation
Home Phone Business Phone

Contact Me

Address of Parent (if different from child):

Doctor's name/address and office telephone:

Known Allergies:

Referred to the school by

Registration fee: A $100 registration fee is required with each application.
New students entering Kindergarten to Grade 8 are required to pay a one-time, non-refundable registration fee of $3,000.
(made payable to the Junior Academy)

Additional Comments/Requests:


For Further information, please contact the school office.
info@junioracademy.com
Telephone 416-425-4567
Dianne Johnson, Principal