Register Now! — Keeseekoose Chiefs Education Centre

Registration for the 2020/2021 School Year is Required!

Student's Name

First Name

Last Name

Date of Birth

YYYY

Learning Option

Grade

Parent / Guardian / Caretaker

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

(###)

###

####

Cell Phone Number

(###)

###

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Emergency Contact

First Name

Last Name

Emergency Contact's Phone Number

(###)

###

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Relationship to the Student

Treaty Number

Health Card Number

Any allergies or other medical concerns?

Notes