Application Form

For Entrance 2023-24

Applicant Information

Does the applicant have a serious allergy (i.e. anaphylactic allergies)?

Current School Information

Student Information

1. Has your child ever been identified as exceptional by a School Identification, Placement, and Review Committee?
One file only.
100 MB limit.
Allowed types: jpg, jpeg, png, pdf, doc, docx.
2. Has your child ever required any special education program or services, including any modified or alternative learning expectations or accommodations?
3. Has your child ever been diagnosed by a medical professional (such as a doctor, psychiatrist, or psychologist) as any one or more of: Behavioural; Autistic; Deaf, hard-of-hearing, or other Language impairment; Speech impairment; Learning disability; Giftedness; Mild intellectual, Developmental, or Physical disability; and/or Blind or low vision?
4. Has your child ever received support from a special education teacher?
5. Has your child ever been suspended or expelled from a school?

Please note that Leahurst College is relying upon your answers to the above five questions to its detriment, pending the future receipt of your child’s Ontario Student Record and any other student records from outside of Ontario. Should the future receipt of any of these records not confirm the veracity of your answers to the above five questions, then Leahurst College reserves the right to immediately terminate the enrollment of your child, at the sole and exclusive discretion of the Head of School.


Uniform Order Information

Please provide all measurement information in inches

Family Information

Parent #1

Parent 1 title
Parent 1 address

Parent #2

Parent 2 title
Parent 2 address


General Information


Compliance with the rules of the school by the parents and student is understood as a condition of the student’s admission. In consideration of Leahurst College admitting and undertaking the education of the above named as a student, the undersigned hereby agrees to pay Leahurst College all fees and charges that shall at any time hereafter become due and payable in respect of such student. The information provided in this application remains the confidential property of Leahurst College.

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