Student Registration — IPC Academy

Medical Information

Medical Conditions*

Include allergies, required medications, or specific health conditions. Write N/A if none.

Health Card Number

Educational Background

Has the student ever been identified as in need of special education?

If Yes, a copy of the IEP is required. If not provided, the school reserves the right to decline registration.

NoYes — IEP copy required

Previously Attended School

School Phone

Date Last Attended

Last Grade Completed*

Previous School Type / Board

Child is Under the Custody of

Both ParentsMotherFather

Other:

Please provide the last 2 report cards. Email to principal@ipcacademy.ca or bring to the office Mon–Fri 8AM–4PM.

Parent / Guardian #1

Last Name*

First Name*

Gender

FemaleMale

Address (if different from student)

Street #

Street Name

Apt. #

City / Town

Province

Postal

Home Phone

Work Phone

Cell Phone*

Email*

Parent / Guardian #2

Last Name

First Name

Gender

FemaleMale

Address (if different from student)

Street #

Street Name

Apt. #

City / Town

Province

Postal

Home Phone

Work Phone

Cell Phone

Email

Document Uploads

Attach documents if available — max 5 MB each (PDF, JPG, PNG).

You can also bring originals Mon–Fri 8AM–4PM or email principal@ipcacademy.ca.

Passport-sized Photo

A clear recent photo of your child.

Birth Certificate / Status

Birth certificate, passport, PR card, etc.

Immunization Records

Official records from your health provider.

Health Card (OHIP)

Student's Ontario health card.

Privacy Notice & Certification

Personal information collected during registration and while attending the school is done pursuant to the Education Act. It will be used for school planning and programming, home and school communications, and to establish the Ontario Student Record (OSR). The registration form is retained in the student's OSR by the registering school for 5 years (post retirement). Direct any questions to the school principal.

I hereby certify that the included information is accurate to the best of my knowledge and I understand that it is my responsibility to advise the school immediately of any changes.

Signature of Parent / Guardian*

Date*