APPLICATION FOR ADMISSION

2018-2019 School Year

 

Applying For:  Secondary 1 | Secondary 2 |  Secondary 3 |  Secondary 4 |  Secondary 5

 

APPLICANT INFORMATION

 

Last name (as it appears on eligibility certificate): 

 

First name (as it appears on eligibility certificate):

 

Date of Birth:  / /

 

Place of Birth (if in Canada, please indicate province):

 

Permanent Code (found on eligibility certificate and/or report card):   

 

Medicare Number:    Expiry Date:  /

 

Applicant lives with: 
(When the applicant lives with Mother & Father, please input Home Address in Mother's section of the form.)

 

Check any that apply:  Mother deceased  Father deceased  Parents separated  Parents divorced

 

Mother Tongue:                                     Language Spoken at Home: 

 

 

APPLICANT EDUCATION

 

Current School:

 

School Board: 

 

Has the applicant applied for admission to Loyola in previous years?   

 

Has the applicant been enrolled in a French school?    If so, how long? 

 

Has the applicant been enrolled in a French immersion program?    If so, how long? 

 

Is the applicant on an IEP? 

If yes, please describe below and include a copy of his IEP when sending in his report card.

Does the applicant have a diagnosed learning disability (e.g. dyslexia, A.D.D.)? 

If yes, please describe below and include a complete copy of any Learning Assessment that has been done.

 

FAMILY INFORMATION

 

FATHER OR GUARDIAN

 

Title:

 

Last name:   First name:

 

Place of Birth (if in Canada, please indicate province):

 

Home Address:

                             No.                Street                                     Apt.                              City                  Province

 

                       

                        Postal Code

 

Home Phone:                          Cell Phone:

 

Preferred e-mail address(es) for receiving information from Loyola High School?

 

    

Email Home                                Email Work

 

 

Profession:    Job Title:

 

Company:

 

Work Phone:    Extension:

 

 

MOTHER OR GUARDIAN

 

Title:

 

Last name:   First name:

 

Place of Birth (if in Canada, please indicate province):

 

Home Address:

                             No.                Street                                     Apt.                              City                  Province

 

                       

                        Postal Code

 

Home Phone:                          Cell Phone:

 

Preferred e-mail address(es) for receiving information from Loyola High School?

 

    

Email Home                                Email Work

 

 

Profession:    Job Title:

 

Company:

 

Work Phone:    Extension:

 

 

RELIGION INFORMATION

 

Loyola is a Jesuit school, founded in 1896 to serve the English Catholic population in Montreal. 
It is assumed that by applying to Loyola, applicants are willing to learn about the Catholic religious tradition and are committed to their own spiritual growth.

 

Religion:    Place of Worship: 

 

If Place of Worship is not listed in the drop-down menu, please indicate here:

 

 

 

ADDITIONAL INFORMATION

 

Please list by priority (numbers 1 to 6) your reasons for supporting your son’s application to Loyola?

 

Discipline                                                 Jesuit Tradition                            Other

 

Sports Program                                        Religious Education

 

Classroom Instruction                              Extra Curriculars

 

Relatives who attend or have attended Loyola High School

 

                                           Name                                                          Year Graduated

 

Grandfather                         

 

Father                                   

 

Brother/s                              

                                   

                                                    

 

                                        

 

Other                                      

     (please specify)                 

 

 

How did you learn about Loyola High School?

 

Relatives     Friends   Website   Reputation   Parish Referral  

 

Print Advertisement, if so, please name the paper:   

 

Other,     

 

OPTIONAL PARENT STATEMENT

 

Please make whatever comments you would like about your son. His intellectual or personal qualities,
demonstrated through specific examples or anecdotes, are especially helpful in our evaluation of the applicant.