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Please fill in this form and complete all parts. Upon submission, you will be required to submit a non-refundable fee of $350 which is payable by cheque or electronically to:

Claremont Educational Services, Inc.
Admissions, The Claremont School
C-1, 310 Danforth Avenue
Toronto, ON M4K 1N6

**Please complete all fields**

Student Information

Full Name
Year applying for:
Grade applying for:
Date of Birth:
Child lives with:
Home Address
Current School:
School Address:
Diagnosis of dyslexia or learning disability by a doctor or psychologist:
Allergies:
Medication:

If available, please upload, or mail us the following:

• 3 most recent report cards

• Individual Education Plan (IEP)

• IPRC Information

*valid file formats are .jpg, .pdf, .gif*

Upload File(s):
Application Fee*

Parents' Information

Parent 1

Parent 1 Name:
Occupation - Parent 1:
Address - Parent 1:
Home Phone - Parent 1:
-
Cell Phone - Parent 1:
-
Work Phone - Parent 1:
-
Work Place - Parent 1:
Work Address - Parent 1:
E-mail - Parent 1

Parent 2

Parent 2 Name:
Occupation - Parent 2:
Home Address (if different):
Home Phone - Parent 2: (if different)
-
Work Phone - Parent 2:
-
Cell Phone - Parent 2:
-
Work Place - Parent 2:
Work Address - Parent 2:
E-mail - Parent 2
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