Entrance Application

This form may be printed and then filled out by hand, or filled out on a computer and then printed.
Please remember signature and date at the bottom.
Tempo School, 5603 - 148 Street, Edmonton, Alberta, T6H 4T7
Fax: (780) 430-6209

I. Student Information

Surname:
Given Name(s):
Date of Birth (dd/mm/yy):
Sex (m/f):
Student's Phone Number:
Street Address:
City/Town:
Postal Code:


II. Parent Information

A. Mother or Legal Guardian
Title (Dr., Ms.):
First Name:
Surname:
Home Phone Number:
Work Phone Number:
Email:

B. Father or Legal Guardian
Title (Dr., Mr.):
First Name:
Surname:
Home Phone Number:
Work Phone Number:
Email:


III. Residency Information (check one)

Canadian Citizen Landed Immigrant Foreign Student Visitor Student Visa
For Student Visa, please complete the following: Visa Number:
Expiry Date (dd/mm/yy):


IV. Present School (this includes Kindergarten)

Name of School:
Present Grade:
City/Town where School is Located:
Province:



How did you hear about Tempo School?
Other:

Signature of Parent/Guardian: ______________________________________________

Date Signed: ___________________________________