École St. Thomas Student Registration

Please fill out the following form completely and to the best of your knowledge. Once submitted a member of our staff will be in touch to confirm registration and answer any questions you may have. 

École St. Thomas is a French Immersion Elementary School with programming for Kindergarten to Grade 7.

The primary mandate of Catholic Schools is to provide a faith-based Catholic Education for families of the minority faith (Catholic). However, in alignment with our belief that Catholicity is inclusive, both Catholic and non-Catholic students shall be admitted to Lloydminster Catholic School Division upon meeting the following criteria: Prospective students and their parents must agree to follow the policies, procedures and practices of the Lloydminster Catholic School Division. This expectation applies to faith-related activities in particular, but may also apply to any action where beliefs in the school division differ from those of the general public.

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École St. Thomas Registration

Grade*
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Registration*
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Student Information

Student Legal Last Name*

(as shown on birth certificate)

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Student Legal First Name(s)*

(as shown on birth certificate)

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Student Legal Middle Name(s)

(as shown on birth certificate)

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Preferred Last Name

(if different than above)

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Preferred First Name(s)

(if different than above)

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A copy of the student’s birth certificate or citizenship documentation is required for proof of legal name, age, and citizenship.

Date of Birth*
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Gender*
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Home Phone
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(###)###-####

Select Residence Type*

Civic indicates city/town addresses; rural indicates acreages and farms.

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Residential Address*

Provide apartment / house / street information, as applicable.

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City/Town*
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Province*
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Postal Code*
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Mailing Address

Provide box number or other applicable mailing information.

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City/Town
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Province
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Postal Code
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Mailing Address*

Provide box number or other applicable mailing information.

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City/Town*
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Province*
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Postal Code*
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Land Location
Quarter Section*
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Section*
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Township*
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Range*
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Meridian*
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Medical Information

Health Care Number*
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Region*
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Specify
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Please indicate specific medical conditions your child may have which require the attention or services of school personnel.
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If your child requires medical attention at school, please refer to AP 316. Complete the required forms and provide them to your child's school.

School History

Last School Attended
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Telephone
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(###)###-####

Town/City
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Province
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Postal Code
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Country
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Has student ever attended another Lloydminster Catholic School?*
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If yes, indicate name of school.
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Has student ever attended school in Alberta?*
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Has student ever attended school in Saskatchewan?*
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Parent/Guardian Information

If there are more than two parents or guardians (step-parent, etc.), it is important to provide the school with this information.
Parent 1
Last Name*
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First Name*
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Catholic*
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Relationship to Student*
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E-mail Address*
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Telephone
Residential*
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(###)###-####

Work
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(###)###-####

Extension
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Cell
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Address

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City/Town
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Province
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Postal Code
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Lives with student*
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Send Mail To*
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Contact Priority*
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Parent 2
Last Name
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First Name
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Catholic
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Relationship to Student
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E-mail Address
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Telephone
Residential
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(###)###-####

Work
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(###)###-####

Extension
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Cell
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(###)###-####

Address

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City/Town
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Province
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Postal Code
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Lives with student
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Send Mail To
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Contact Priority
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Parent 3
Last Name
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First Name
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Catholic
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Relationship to Student
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E-mail Address
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Telephone
Residential
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(###)###-####

Work
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(###)###-####

Extension
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Cell
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(###)###-####

Address

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City/Town
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Province
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Postal Code
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Lives with student
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Send Mail To
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Contact Priority
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Parent 4
Last Name
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First Name
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Catholic
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Relationship to Student
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E-mail Address
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Telephone
Residential
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(###)###-####

Work
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(###)###-####

Extension
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Cell
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(###)###-####

Address

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City/Town
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Province
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Postal Code
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Lives with student
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Send Mail To
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Contact Priority
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Guardianship, Custody, or Access Rights

Guardians of the student must be identified to ensure each party’s rights are respected. If an order affecting guardianship rights or custody or access rights exists, a copy of the order will be placed on the student record. In rare instances, a child may be designated as “protected” if a court order has been issued under the Child Welfare Act, the Domestic Relations Act, the Divorce Act or the Young Offenders Act.
Does any such order or agreement affecting the safety, security, custody, or access of the child exist?*
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If yes, please arrange to meet with the school administration. Legal documentation will be required.

Additional Contact Information

Emergency Contact

(someone other than parents)

Last Name*
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First Name*
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Relation to Student*
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Telephone
Residential*
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(###)###-####

Work
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(###)###-####

Extension
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Cell
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(###)###-####

Address*
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City/Town*
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Province*
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Postal Code*
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Emergency Contact

(someone other than parents)

Last Name
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First Name
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Relation to Student
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Telephone
Residential
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(###)###-####

Work
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(###)###-####

Extension
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Cell
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(###)###-####

Address
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City/Town
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Province
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Postal Code
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Babysitter/Daycare
Last Name
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First Name
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Or
Daycare Name
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Telephone
Residential
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(###)###-####

Work
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Extension
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Cell
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Address
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City/Town
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Province
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Postal Code
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Billet Information For Students Residing Outside Lloydminster City Limits

In the event buses are unable to run, we require a billet home within Lloydminster city limits for your child.

Please indicate who would be responsible for billeting your child.

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If Additional Contacts are not residents of Lloydminster, provide the name and contact information of a Lloydminster resident.
Last Name
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First Name
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Telephone
Residential
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(###)###-####

Work
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Extension
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Cell
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(###)###-####

Address
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City/Town
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Province
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Postal Code
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Sibling Information

Please provide information regarding siblings of the student.

Sibling's Full Name
Date of Birth
School Sibling Attends

(if applicable)

Lives with Student

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Citizenship of Student

Citizenship*

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Check the appropriate box to indicate which required document has been provided to the school to support citizenship.

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Check the appropriate box to indicate which required document has been provided to the school to support citizenship.*

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Check the appropriate box to indicate which required document has been provided to the school to support citizenship.*
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Expiry Date*
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Check the appropriate box to indicate which required document has been provided to the school to support citizenship.*
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Expiry Date*
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Check the appropriate box to indicate which required document has been provided to the school to support citizenship.*
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Expiry Date*
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Language

First Language spoken*
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Second Language spoken

(if applicable)

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Program

Does your child have any physical, intellectual, behavioral, or emotional needs which may require additional educational assistance, modification, or adaption beyond the regular educational program?*
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If yes, please describe the needs of your child in the space below.
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Aboriginal Declaration

If you wish to declare that your child is an Aboriginal person, please specify one of the following.

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AB Education and the SK Ministry of Education collect this personal information pursuant to section 33(c) of the Freedom of Information and the Protection of Privacy (FOIPP) Act as the information relates directly to and is necessary to meet Ministry and School Board mandates and responsibilities to measure system effectiveness over time and develop policies, programs and services to improve Aboriginal learner success. This information will also be used to determine the provincial First Nations, Métis and Inuit Funding Allocation provided to school jurisdictions. For further information or if you have questions: AB residents: www.education.alberta.ca/system-supports/results-reporting or AB Education 780-427-8501. Questions related to collection of information by the school board, contact our division office at 780-808-8585. SK residents: write to Lloydminster Catholic School Division at 6611B 39 Street, Lloydminster, AB, T9V 2Z4, or call 780-808-8585.

Religion of Student

Catholic*
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If you have indicated Yes, your child’s name and contact information will be shared with St. Anthony’s Parish, Lloydminster, AB in order to assist with the distribution of their information regarding sacramental preparation.

Sacraments student has celebrated

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(check those that apply)

If your child has been baptized in the Catholic church, please provide a copy of the baptismal certificate.

If religion is anything other than the Catholic faith, please sign the following acknowledgement.

The primary mandate of Catholic Schools is to provide a faith-based Catholic Education for families of the minority faith (Catholic). However, in alignment with our belief that Catholicity is inclusive, both Catholic and non-Catholic students shall be admitted to Lloydminster Catholic School Division upon meeting the following criteria: Prospective students and their parents must agree to follow the policies, procedures and practices of the Lloydminster Catholic School Division. This expectation applies to faith-related activities in particular, but may also apply to any action where beliefs in the school division differ from those of the general public.

Signature of Parent or Guardian
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Freedom Of Information And Protection Of Privacy Act (FOIPP) – Parental Consent

Occasionally, schools publish, in a variety of formats, student names, photographs, achievements, etc. for education, instructional, informational, or promotional purposes. It is important for us to be informed of your wishes regarding division and media coverage of student achievements, photographs, and activities during the time your child is a student within our school division. The Freedom of Information and Protection of Privacy Act (FOIPP) requires that parents/guardians control the manner in which student information is displayed, distributed, or published. By checking “I do” below, you will be consenting to the following uses of student information, but not limited to:

  • Student names attached to their art work or written material that are displayed in school division facilities
  • Individual photos that are taken and used within the school, communications, yearbook
  • Photos and/or videos of classroom and school activities that are included in the yearbook and/or displayed in school division facilities
  • Team or class photos used within school division facilities or yearbook
  • Posting of photos, videos, names of student involved in school-based activities (i.e.: sports, graduation, school interviews, etc.), on social media (Facebook, website, etc.), and/or within the local media
  • Student names and description of activities that are used in the school newsletter or other communications
  • Student participation in video-conferences and subsequent recordings to be used for educational purposes

The above listing has been summarized. For the complete document, see the FOIPP Act at the following link.

http://www.qp.gov.sk.ca/documents/English/Statutes/Statutes/F22-01.pdf

*

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The school may not restrict photos and/or videos of public school events taken and used for purposes within and outside of the school.
Parent Name*
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Date
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Signature
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Network - Parent Permission And User Agreement Form

Parent Agreement:

I have read AP 145 "Network Services: MAN/Internet Access" and the related appendices. I understand that this access is designed for educational purposes. Lloydminster Catholic School Division has taken precautions to eliminate material. However, I also recognize that it is impossible for Lloydminster Catholic School Division to restrict access to all controversial materials and I will not hold the Board of Education of the Lloydminster Catholic School Division or any of its officials or employees responsible for materials acquired on the network. Further, I accept full responsibility for supervision if and when my child’s use is not in a school setting. I hereby give permission to issue an account for my child and certify that the information contained on this form is correct.

Parent Name*
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Date
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Signature
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Student Agreement:

In consideration of the Lloydminster Catholic School Division permitting me, the undersigned student (User) to have access as a User of the Internet Service described above, I hereby acknowledge and understand the above Internet terms and conditions and I agree to comply therewith and be bound thereby. I further understand that any violation of the guidelines may constitute a criminal offence. Should I commit any violation of the law or contravene any term or condition set out above, my access privileges may be revoked, school disciplinary action may be taken, and/or appropriate legal action may be taken against me.

Student Name*
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Date
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Signature
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Disclosure

Lloydminster Catholic School Division may use the information collected on this form to assist in providing appropriate educational programming and support for the student. Contact information is collected to help us communicate effectively with the student’s parents or guardians. Some of this demographic data may be shared with Ministries we work with to provide services to our students (including, but not limited to, Education and Health). We collect the student’s health number to use in the event medical care is needed. This number, and other demographic information, is shared with the SK and AB Ministries of Education. For SK students, this data will also be used to support the Student Tracking Program. How this information is accessed, used, or disclosed is protected under the Freedom of Information and Protection of Privacy Act and the Local Freedom of Information and Protection of Privacy Act.

Declaration

I declare that the information I have provided on this registration form is complete and correct. I hereby affirm that I have read this form and understand how the information collected will be used. As indicated by my signature below, I consent to have the information provided by me accessible as indicated and to abide by the philosophy, policies and regulations of the Lloydminster Catholic School Division.

Signature
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Date
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Request for Cumulative Record Transfer

L’élève suivant est inscrits à l’École St. Thomas. Veuillez, s'il vous plaît, nous faire parvenir leur carte cumulative, toutes autres informations pertinentes et le numéro d’identification provinciale pour l’élève. Merci de votre coopération.

The following student has enrolled at École St. Thomas. Please forward the cumulative record and any other relevant educational information that may be of assistance. Include a copy of this request with the cumulative record.

Important information as we are a Saskatchewan school:

  • SK schools, please provide the SK Provincial Learning Identification Number. Please send the original cumulative record.
  • AB schools, please provide the AB Student Number. Send a copy of the cumulative record, not the original.
  • All other provinces, please send a copy of the cumulative record.

Thank you for your assistance.

Student Information

Legal Last Name(*)
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Legal First Name(s)(*)
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Legal Middle Name(s)
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Preferred Last Name

(if applicable)

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Preferred First Name(s)

(if applicable)

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Date of Birth(*)
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Date of Request (office only)

SK Learning ID
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AB Student Number
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Previous School
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Previous School Address
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Previous School Phone Number
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(###)###-####

Previous School Fax Number
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Anti-Spam
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