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Kelowna's very own,
Heritage Christian School International.

The Right Choice for
International Education.

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Student Application and Profile Form

Students Information

Date of application
Present grade
Grade applying for
Date of admission requested
Expected withdrawal date

Date of birth (according to your passport)
Place of birth
Age
Gender	Male Female
Last name
First/middle names
English/Canadian name
Nationality
Permanent address Street, City, Province/State, Country, Postal/Zip
Home phone #
Fax #
Email address 1
Email address 2
Father's name
Mother's name

Additional Parent or Custodian Information

Father's Information
Cell phone #		Work phone #
Occupation		Date of Birth (Year/Month/Day)
Mother's Information
Cell phone #		Work phone #
Occupation		Date of Birth (Year/Month/Day)

Custodianship / Guardianship and Visa Information

If you are working with a student placement agency, or a Canadian relative or representative please give names and contact information for your representative.

Agency name (if applicable)
Contact name
Agency phone #
Contact cell #
Representative address (if applicable)
Email address
Fax #
Have you made specific arrangements for custodianship / guardianship of your child while they are in Canada?
	Yes No
If yes, please indicate name and contact information for your child’s intended custodian / guardian.
	Last name
	First/middle names
	Permanent address Street address, city Province/State, Country, Postal/Zip
	Relationship to student
	Male or Female	Male Female
	Phone #
	Cell #
	Fax #
	Email

Homestay Information

Do you require homestay accommodations?	Yes No
Members in your family
Name		Relationship
Name		Relationship
Name		Relationship
Name		Relationship
Name		Relationship
Many Canadian families have pets (for example: cats, dogs, birds etc)
Do you like pets?	Yes No
Would you like to stay in a home with children or teenagers?
Children	Yes No No Preference
Teenagers	Yes No No Preference
What activities, sports, hobbies, or interests do you enjoy when you are not studying?

If there is any other information you can provide that is pertinent and/or related to your child’s registration? Please include it below.

Have you read and understand the financial commitments as explained in the Heritage Christian School International Student Application?
	Yes No
Heritage Christian School is collecting and maintaining the information requested on this form for the purpose of assessing the eligibility of International Students for International Education programs within its campus and for placement in a suitable home.

Home Stay Information and Fees

If requested, Heritage Christian School will make arrangements for your child to live with a Christian Canadian Host Family. We make every effort to accommodate your request and match your child with children of similar ages. The family will provide three meals per day, transportation to and from school (high school students may choose to take the city bus), and give them support needed to live here in Kelowna. Students will become proficient in English and Canadian culture by choosing to live in a Homestay situation.

Homestay Fees: The monthly and daily Homestay fees for Middle/High School students are $700/ month ($28/day) and for Elementary School students, they are $800/month ($30/day). The fees are paid at the beginning of the year and held in trust by the school for monthly disbursement to the homestay family. If your child does not attend for the whole term, as stated in your application, there must be at least one month notice given to the school. If notification of withdrawal is less than one month, the Homestay family will receive the fees for the current month and one more month in lieu of proper notification.

Church Life

Name of church your family regulary attends
Church address Street address, City Province/State, Country, Postal/Zip
Pastor
Church phone #
The Pastor’s Reference Form must be completed and forwarded to the office. Fax 250-862-4943 or email international@heritagechristian.ca

Medical Data

Does your child have any allergies? If "Yes", please describe.
Does your child take any medication on an on-going basis? If "Yes", please state what the medication is and the condition that is being treated
Will the school be administering the medication? If "Yes", please download the medical forms off the Internet and have them completed by a guardian and the doctor.
Does your child have any serious or potentially life threatening medical conditions? If "Yes", please describe.

School Data

How did you learn of HCS?
What are the reasons for enrolling your child in HCS?
Please list the last school(s) your child has attended.
School name		School name
Phone		Phone
Dates		Dates
Address		Address
Has your child ever been suspended or expelled from school? If "Yes", please explain

Academic Data

English Proficiency
How many years of English training has your child received?
Has your child received private English lessons?	Yes No
If "Yes" , how long?
How would you describe your child’s written and spoken English?
Learning Disability
Has your child ever been assessed for and/or diagnosed with a learning disability (including ADD, ADHD, Emotional Distress, or other)?	Yes No
If "Yes" , please explain and attach the most recent copy of the assessment.
Social
Has your child ever been involved in unlawful and/or violent behavior?	Yes No
If "Yes", please explain.
Academic Progress
Describe your child’s general academic progress. What would be his/her strengths and weaknesses?

Personal

We believe that children can place their trust in Christ as their personal Savior and we teach this at HCS. It is important for us to know if your child has done so. When parents and children both support the elements of faith and practice as we believe and teach within the HCS community, the educational experience is much more satisfying. Please comment on your child’s spiritual condition and response to spiritual teaching.

Conditions of Registration

Please check each condition
	I/We have read the Student/Parent Handbook (Admission Policy , below) and understand the commitment we are making.
	I/We agree to abide by the school rules and guide our child to uphold the Code of Conduct and discipline of the school as outlined therein.
	I/We certify that all information on this application is complete and correct.
	I/We authorize Heritage Christian School to verify any of the information submitted herewith.
	I/We agree that it is the responsibility of the parent(s) to stay in contact with the school as to the progress of my child and will access Student’s Achieve, via the internet, for their weekly progress.
	I/We agree that work produced by our child(ren) may be used for promotional purposes such as HCS sees fit.
	Please ensure that the following documents are received by the office. Fax 250-862-4943 or email international@heritagechristian.ca My child’s most recent Progress Report Birth certificate A copy of health insurance Passport Pastor’s Reference Form Appropriate documents in regards to citizenship status (Visa) Personal student letter (for grades 6-12)

Signatures

Parent/Custodian 1:
I validate this to be used as my signature and authorization, dated .

Parent/Custodian 2:
I validate this to be used as my signature and authorization, dated .

Protection of Personal Information

From time to time we must send your child’s personal information outside of the school to a few organizations we deal with for educational purposes. This information is carefully selected and will not be used by third parties for advertising or other unauthorized uses.

Ministry of Education
Other HCS families via our school directory or newsletter
Community Health Clinic
Other educationally related businesses
Other schools/school organizations
Media for sporting or promotional events
Community Programs (YMCA etc.)
Sports organizations

I give permission for Heritage Christian School to use my personal information for the above stated uses and any photos that may be taken of my child on activities or in the classroom for promotional and advertising purposes.

Signature:
I validate this to be used as my signature and authorization, dated .

Tuition and Fees - all funds are in Canadian dollars

Application Fee	One-time (non-refundable)	$125.00 CDN
Tuition - 10 months	Full year	$10,000.00 CDN
Medical **	All students must purchase either private or government medical insurance as a condition of their acceptance	Approximately $700 .00 CDN for a full school year
Homestay Finder’s Fee	Non-refundable	$175.00 CDN
Please Note:	A non-refundable Application Fee of $125 must accompany the application A non-refundable Homestay Finder’s Fee of $175.00 must also accompany the application Once your application is received, you will be contacted to arrange an Interview time Upon approval of your application, you will then be invoiced for the remaining tuition and fees owed All fees are to be paid prior to the Letter of Acceptance being issued Any student registering for a partial year or semester will be pro-rated and charged an additional 10% **MSP coverage is required by law in BC for any student studying longer than 6 months. Private insurance is then required for students studying for less than 6 months Additional Fees may be applicable to students who are in need of extra services such as: change of homestay, tutoring, etc

Tuition and Payment Information

Tuition is received to cover the costs of education for your children in Canada. We are a Group 1 Independent School, registered with the Province of British Columbia and can only receive government funding for students whose parents reside in British Columbia. Students from outside Canada all pay the same fee, regardless of grade level. Payment is required at the beginning of the school year unless other arrangements are made with our financial department.

Method of Payment: Payment may be made by credit card, bank draft, cash, cheque or electronic bank transfer directly to the school. Please contact the school for specific wire transfer information.

Refund Policy

*Before the program begins.*
	Student Receives	HCS Retains
If Visa is denied.	Remaining tuition	$500
Less than 7 days after registration	75% of tuition	25% of tuition
30 Calendar days or more before the start of class	75% of tuition	25% of tuition
Less than 30 days before the start of class	60% of tuition	40% of tuition

*After the program begins.*
	Student Receives	HCS Retains
Before 10% of program duration	50% of tuition	50% of tuition
Between 11% and 30% of program duration	30% of tuition	70% of tuition
After 30% of the completed program	0% of tuition	100% of tuition

Please note: Application Fees and Homestay Finder’s Fees are non-refundable.

Your program is indicated by the start and end dates of your signed application form.
Tuitions fees are non-transferable.
All requests for refunds must be made in writing and given to reception.
Refund requests must include the original Letter of Acceptance issued by Heritage Christian School as well as any supporting documentation.
If you are denied authorization from Citizenship and Immigration, a copy of the letter stating that you are denied is required. A full refund less $500.00 will be given.
If you are eligible for a refund, you will receive the refund within 90 days of your written notice.
Canada Immigration will be contacted when students withdraw prematurely from the program.
NO REFUND will be given to a student who is dismissed from the program due to a breach of law, policy, regulation, or student code of conduct.