Student Name:___________________________ Entry Grade:_____________________________ Permanent Code:_________________________ Bialik High School Les Écoles juives populaires et les écoles PERETZ INC. ADMISSIONS TESTING: SECONDARY 1 APPLICANTS MUST REGISTER FOR THE COMMON ADMISSION TEST (CAT) AT www.registrationbl.qc.ca *Please note that JPPS graduates are exempt from writing the CAT, unless they wish to be considered for the International Baccalaureate Middle Years Programme (IBMYP) Certificate Stream. Applications due: October 24th 2014 Application Package 2015–2016 1 CHECKLIST FOR APPLYING TO BIALIK HIGH SCHOOL The following documents are required, along with a completed application form: A $50.00 non-refundable application fee and a $200 deposit (see page 4 of package). The $200 deposit will be applied against the 2015-2016 school fees for successful applicants. An authenticated copy or true copy (but not photocopy) of the student’s birth certificate showing full names of parent(s) (to be copied while you wait and returned to you immediately). Student’s original certificate of eligibility (“Déclaration d’admissibilité à l’enseignement en Anglais”) issued by le Ministère de l’Éducation, Loisir et Sport (MELS) (to be copied while you wait and returned to you immediately). This requirement is for students in the English Sector only. Proof of citizenship of the parents (passport). A copy of the student’s most recent report card. The completed Common Confidential School Report Form to be submitted by the applicant’s current school directly to Bialik High School. Passport-sized photograph of student. If applicable, a copy of the applicant’s educational assessments. Applicants to Secondary 1 are required to complete the Common Admissions Test (CAT). Please refer to our Important Admissions Dates document for dates and times. Following receipt of your application, student and parents will be invited to participate in a Family Interview. Notification and Confirmation of Acceptance or Refusals: Bialik High School is part of the Quebec Association of Independent Schools (QAIS) and follows QAIS procedures and deadlines. Letters of acceptance will be sent on or after November 3, 2014. Acceptances should be confirmed by parent(s), in writing, within 10 days of notification. All documents should be submitted to: Admissions Bialik High School 6500 Kildare Road Montreal, Quebec H4W 3B8 For further information, please contact Nancy Sculnik, Vice-Principal at (514)223-2736 or via email at [email protected] 2 בתי ספר עממיים יהודיים ובתי ספר על שם פרץ LES ÉCOLES JUIVES POPULAIRES ET LES ÉCOLES PERETZ INC. JEWISH PEOPLE’S SCHOOLS & PERETZ SCHOOLS INC. יידישע פאלקס שולן און פרץ שולן BIALIK HIGH SCHOOL - APPLICATION FOR ADMISSION Please print clearly. Date of application: ____________________________________ For academic year: __________________ FAMILY INFORMATION Mother (Full Name): ____________________________ Mrs. Ms. Dr. Prof. Father (Full Name): ____________________________ Mtre. Mrs. Ms. Dr. Prof. Mtre. Address______________________________________ Address______________________________________ ________________________ Postal code: _________ ________________________ Postal code: _________ Home Tel:____________________________________ Home Tel:____________________________________ Cell: ________________________________________ Cell: ________________________________________ E-mail: ______________________________________ E-mail: ______________________________________ Fax: ________________________________________ Fax: ________________________________________ Occupation / Title: _____________________________ Occupation / Title: _____________________________ Place of Birth: ________________________________ Place of Birth: ________________________________ Work tel.: ____________________________________ Work tel.: ____________________________________ Work E-mail:__________________________________ Work E-mail:__________________________________ Mother’s license plate #:_________________________ Father’s license plate #: _________________________ Marital status: _________________________________ (Married, Divorced, Single, Widowed, Remarried) Student lives with: Both Mother Father Guardian If applicable Guardian (Full Name): ____________________________ Responsible for School Fees: Mother Father Both Other ____________________ Address: ______________________________________ __________________________ Postal code: _________ Home Tel:_______________ Cell: __________________ E-mail: _______________________________________ Correspondence to be sent to: Fax: _________________________________________ Both Mother Father Guardian Occupation / Title: _______________________________ Place of Birth: __________________________________ Work tel.: ______________________________________ Work E-mail: __________________________________ Guardian’s license plate #: _________________________ 3 CHILD INFORMATION Family name: ________________________________________ Given name: _____________________________ Student’s cell: _____________________________________ Hebrew name: ___________________________ School previously attended: ____________________________ Grade of entry: _____________ Gender(M/F): Mother tongue (E, F, H…) Birth date: ______ / ______ / _______ dd mm yy Birth place: Quebec Other ____________________ Language at home (E, F, H…) Permanent code: _____________________________ Medicare #: _____________________________ Exp. ________ EMERGENCY CONTACTS Name: ______________________________________ Name: ______________________________________ Telephone: __________________________________ Telephone: ___________________________________ Relationship:__________________________________ Relationship: _________________________________ Consent to Receive Information We hereby give permission to __________________________________ to release information to (name of elementary or previous school) Bialik High School regarding our child’s personal file. ___________________________________________ Parent’s signature ____________________ Date Child Information Previous Schools Attended 1. ____________________________________________ from Grade _______ to Grade _______. 2. ____________________________________________ from Grade _______to Grade _______. Applicants for Secondary II or higher: Does the student’s present school know that you are exploring entry to other schools? Yes No Does your child take any medications or have any illness or disability of which the school should be aware? ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Other information about your child that may be helpful to the school or teachers: ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Office Use Only Date sent ________________ Date received: ________________________ Eligibility certificate received: Y N Parent’s passport received Y N Letter of acceptance sent Y N Family number: _____________________ Birth certificate received: Y N 4 For an explanation of each of the following programs, please see the following page. Does your child wish to be considered for the International Baccalaureate Middle Years Programme (IBMYP)? Yes No Is your child applying to the Academic Support Program? Yes No Is your child applying to the Section française? Yes No If your child is enrolling in the English section, would you like him/her to be considered for: French mother tongue OR French as a second language? Arts Option: Secondary I applicants only: Please check off your child’s first choice: (Please note that students in section française will be enrolled in art dramatique). Drama Music Fee Assistance Program If you require flexible tuition or fee assistance, please check this box . You will be contacted upon your acceptance with a fee assistance application package. 5 International Baccalaureate Middle Years Programme (IBMYP) - Certificate The IB Middle Years Programme (IBMYP) is a challenging course of study. Students are asked to take responsibility for their learning, to work and cooperate closely with others and to explore new ways of understanding and enquiring into the world around them. The IBMYP is founded on three main principles: holistic learning, communication and intercultural awareness. It asks the learners to make connections: between subjects, between people, between how they act and how their actions affect others. Connections between the school and the wider community are important. Acceptance to the IBMYP at Bialik involves additional admissions criteria and additional costs. Academic Support Program The Academic Support (ASP) program is designed to support students who have been identified with a learning difficulty. Students enrolled in this program have the ability to be successful in high school with the support of smaller classes in core subjects (English, Geography/History and Math for Secondary I), as well as small group support in Science and Math (Secondary I). In subsequent grades, the core subjects and support classes may be different. ASP follows the regular high school curriculum, leading to graduation at the secondary level. Applicants to the program must have a psycho-educational assessment and an Individual Educational Plan ( I.E.P.) and have a certificate of eligibility to study in English. There is an additional cost to the program over and above regular school fees. Other services are available through Student Services. Please contact the school for more information. Section française La Section française de Bialik répond en tous points aux normes des Écoles françaises privées régies par le MELS. Elle en suit le même cursus scolaire avec le même nombre d'heures accordé à chacune des matières. Nos étudiants ont ainsi l'avantage de passer au terme de leurs études, les deux épreuves de langue maternelle (françaises et anglaises) qui les qualifient automatiquement comme étudiants bilingues selon les normes du ministère de l'Éducation du Québec, ce qui leur donne la possibilité d'avoir accès à l'université de leur choix. French, Mother Tongue The advantage of graduating from high school with both English and French mother tongue certificates is significant. The fluency that students develop in French will allow them to be better equipped to succeed in Quebec and is proof of bilingualism. Students will be considered for this course based on placement test results, the elementary school recommendation and the elementary school report card. Arts Option: Secondary 1 applicants only As part of le Ministère de l’Éducation, Loisir et Sport (MELS) curriculum, all students must take an Arts Education course. Students in Secondary 1 will have a choice of Drama or Music. In both drama and music, students will acquire knowledge related to the discipline and will develop performance and appreciation skills as they explore their creativity and artistic sensitivity. Neither program requires any pre-requisite skills or knowledge. As Secondary 1 is part of a cycle of learning that consists of Secondary 1 and 2, the choice of drama or music is for two years. Both options will be offered in the English section, on a first-come-first-served basis, contingent on sufficient registration. For students in section française, the Arts Education option will be art dramatique. 6 Family Information Please list all the children in your family: Name Age Current School and Grade or Occupation Is either parent a JPPS or Bialik graduate? If yes, please indicate year of graduation:________________ from Would you like to be added to our alumni e-mail list? JPPS or Bialik Graduate (Please indicate which school and year graduated) Yes No JPPS Yes Bialik No Payment and Signature Payment of $50 non-refundable file-processing fee by: Mastercard VISA # ____________________________________ Expiry: ______ /_____ _________________________________________________ Cardholder’s name (please print) _____________________________________________ Cardholder’s signature ______________________ Date Cheque (payable to JPPS) Payment of $200 deposit (to be returned if school’s offer of acceptance is declined by the family) by: Mastercard VISA # ____________________________________ Expiry: ______ /_____ _________________________________________________ Cardholder’s name (please print) _____________________________________________ Cardholder’s signature ______________________ Date Cheque (payable to JPPS) ________________________________________ Parent’s signature ______________________ Date 7 www.jppsbialik.ca Admissions Bialik High School 6500 Kildare Road Montreal, Quebec H4W 3B8 8
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