rwelc.director@ssccs.ca      306-683-8390
Royal West Early Learning Centre
Application

Family

Family Name

Family Name
 

Mother (or Guardian)

Relation to Child
First Name Last Name
Home Phone Cell Phone
Address
City
Work Work Phone
Work Address
School School Phone
School Address
Birth Date
Email Address





Father (or Guardian)

Relation to Child
First Name Last Name
Home Phone Cell Phone
Address
City
Work Work Phone
Work Address
School School Phone
School Address
Birth Date
Email Address





First Child

Personal

First Name Last Name
Nick Name
Birth Date Sex
Child Lives With     
Attending grade 1 to 6?   School Name
Is there a custody agreement?
 

Enrolment

Program
Desired Start Date 

Second Child

Personal

First Name Last Name
Nick Name
Birth Date Sex
Child Lives With     
Attending grade 1 to 6?   School Name
Is there a custody agreement?
 

Enrolment

Program
Desired Start Date 

Third Child

Personal

First Name Last Name
Nick Name
Birth Date Sex
Child Lives With     
Attending grade 1 to 6?   School Name
Is there a custody agreement?
 

Enrolment

Program
Desired Start Date 

Wrap Up

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