Pre-primary Program and Grades Primary to 12 Pre-Registration Form
for the 2021-2022 School Year

Please complete the following information to pre-register your child.

Please pre-register my child at *	. Antigonish Education Centre (English and French Immersion Programs offered) Bayview Education Centre Cape Breton Highlands Education Centre/Academy (English and French Immersion Programs offered) Chedabucto Education Centre/Guysborough Academy Dalbrae Academy Dr. John Hugh Gillis Regional High School East Antigonish Education Centre/Academy East Richmond Education Centre (English and French Immersion Programs offered) Fanning Education Centre/Canso Academy Felix Marchand Education Centre (English and French Immersion Programs offered) H.M. MacDonald Elementary School Inverness Education Centre/Academy Pleasant Bay School Richmond Education Centre/Academy Strait Area Education Recreation Centre St. Andrew Junior School St. Andrews Consolidated School St. Mary’s Education Centre/Academy Tamarac Education Centre (English and French Immersion Programs offered) Whycocomagh Education Centre
Please pre-register my child in *	. Pre-primary Primary 1 2 3 4 5 6 7 8 9 10 11 12
Please pre-register my child in *	English Program French Immersion Program (available to Grades P-12 students)

Child Information

Child First Name *
Child Last Name *
Date of Birth *	Day: . 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month: . Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Year: . 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Gender *	. F (Female) M (Male) X (Non-binary or another gender identity)

Is your child receiving services? (ie: Speech Language Pathology, Early Intervention etc.) *

Yes No

Busing is available for all pre-primary children and Grades Primary to 12 students eligible to receive bus service. Please contact the SRCE Transportation Department staff at 902-747-3645 to determine your eligibility to receive bus service.

Parent / Guardian Information

Parent 1

Parent / Guardian First Name *
Parent / Guardian Last Name *
Primary Phone *
Secondary Phone
E-mail Address *

Parent 2

Parent / Guardian First Name
Parent / Guardian Last Name
Primary Phone
Secondary Phone
E-mail Address

Mailing Address

Street, Apartment / Suite *
City *
Province *
Postal Code *

Civic Address: (if different from mailing address)

Civic Street, Apartment / Suite
Civic City
Civic Province