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Student Profile | Grade 1 - 12

Gender: *
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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 *
 
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 your child or has your child received ELL support in the last three years? Or have they been recommend to receive ELL support over the last three year? *

Educational Support Services

Has your child been diagnosed with anxiety? Are there any social or emotional concerns? *
 

Has there ever been behavioural concerns?, or is there currently a behaviour and/or safety plan in place for your child? *
 

Has your child been diagnosed with ADHD? *
 

Has your child received, or is your child receiving, Speech Language Therapy? *
 

Does your child have any academic concerns ( Literacy or Math) *
 
Has your child had, or is your child currently being tutored outside of school? *
 
Has your child repeated any grades? *
 
Is your child scheduled to receive any diagnostic assessments or testing or have they been recommended by the school for an assessment? *
 
Has your child ever received, or is your child receiving, any of the following support services. *
Is your child scheduled to receive any diagnostic assessments or testing or have they been recommended by the school for an assessment? *
 
In the event of an immediate need arising in school, I acknowledge that my child may receive support from the Social Emotional Learning Team (Youth Care Worker, School Counsellor).
 *
 

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 *
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