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Student Profile | Grade 1 - 12

Gender: *
I/we give permission for Langley Christian School to contact my child's previous and/or current school for further information if needed: *
Student is of indigenous ancestry *
Student is of indigenous ancestry *
Does your child have, or has your child experienced, any social issues at school? *
Has your child every been involved in disciplinary action by a school? *
Has your child taken the provincial Literacy Assessment? (Grade 10-12 Only) *
Has your child taken the provincial Numeracy Assessment? (Grade 10-12 Only) *

Medical Information

Can your child participate in a full Physical Education Program? (Note: Physician's note required to miss PE) *
Does your child have any of the following medical conditions: *
Are any of the above conditions life threatening?
Does your child require assistance in taking medications? (If yes, authorization forms are available at main office) *

English Language Learning (ELL)

Is English your child's first language? *
Is your child's current/prior schooling in any language other than English? *
Is there a possiblity that your child will require English Language Learning instruction? If LCS determines ELL instruction is needed for your child, there may be a required fee for instruction. *

Educational Support Services

Has your child repeated any grades? *
Has your child had, or is your child currently being tutored outside of school? *
Has your child received, or is your child receiving, Speech Language Therapy? *
Has your child been diagnosed with ADHD or ADD *
Has your child been diagnosed with Anxiety? are there any social or emotional concerns? *
Does your child have any academic concerns ( Literacy or Math) *
Has there ever been behavioural concerns?, or is there currently a behaviour and/or safety plan in place for your child? *
Is your child scheduled to receive any diagnostic assessments or testing? *
Has your child ever received, or is your child receiving, any of the following support services: If yes, please fill in the LCS Educational Support Services Student Information Form. *
Does your child have an Individual Educational Plan (IEP), Student Learning Plan (SLP), or Learning Support Plan (LSP)? Please attach copy of most recent IEP, SLP , SSP or LSP. *

Child Custody

Has there been Social Services involvement regarding your child? *
Are there court orders regarding custody of your child? *

Emergency Contact

Signed by parent/guardian *