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#2165-8766 McKim Way
Richmond, BC, Canada V6X 4G4
604.278.6811

City Vancouver Academy - High School Graduation Program

DOMESTIC STUDENT APPLICATION FORM

STUDENT INFORMATION

Gender:

FAMILY INFORMATION

Are they EMERGENCY contacts?

 APPOINTED CUSTODIAN / GUARDIAN

Is this EMERGENCY contact?

EDUCATION HISTORY

AGENCY / AGENT / SCHOOL

You do not need to fill in all the information,

you can come to the school to fill it out,

or you can wait for the reply email to fill in the remaining information