Registration Form Name and AddressParent Name* First Last Parent Name First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone Number*Email Address* Minimum Age RequirementSocrates Greek School will only accept students who will be reaching the age of 5 years old by December 31st of the registration year. Student InformationNumber of Students*Select one1 Student2 Students3 StudentsStudent 1 Name* First Last Student 1 Date of Birth* MM slash DD slash YYYY Student 1 Care Card Number*Student 1 T-Shirt ($25)I don't want a T-ShirtS (Youth)M (Youth)L (Youth)SMLXLStudent 1 Medical Concerns or Learning DisabilitiesStudent 2 Name First Last Student 2 Date of Birth MM slash DD slash YYYY Student 2 Care Card NumberStudent 2 T-Shirt ($25)I don't want a T-ShirtS (Youth)M (Youth)L (Youth)SMLXLStudent 2 Medical Concerns or Learning DisabilitiesStudent 3 Name First Last Student 3 Date of Birth MM slash DD slash YYYY Student 3 Care Card NumberStudent 3 T-Shirt ($25)I don't want a T-ShirtS (Youth)M (Youth)L (Youth)SMLXLStudent 3 Medical Concerns or Learning Disabilities School LocationIn person instruction will be at Gilmore School in Burnaby, Fridays 4:30 - 6:30pm Online classes will be arranged by teachersSchool Location* In Person Online Emergency Contact InformationEmergency Contact 1 Name* First Last Emergency Contact 1 Relationship*Emergency Contact 1 Phone*Emergency Contact 2 Name First Last Emergency Contact 2 RelationshipEmergency Contact 2 Phone Payment InformationPayment Method*Select Payment MethodOne Time PaymentMonthly PaymentsFee SummaryAnnual Registration Fee Price: Annual Tuition: Price: $ 0.00 CAD Annual Educational Resources: Price: $ 0.00 CAD T-Shirts: Price: $ 0.00 CAD 1 T-Shirt (Youth S): $251 T-Shirt (Youth M): $251 T-Shirt (Youth L): $251 T-Shirt (Small): $251 T-Shirt (Medium): $251 T-Shirt (Large): $251 T-Shirt (XLarge): $251 T-Shirt (Youth S): $251 T-Shirt (Youth M): $251 T-Shirt (Youth L): $251 T-Shirt (Small): $251 T-Shirt (Medium): $251 T-Shirt (Large): $251 T-Shirt (XLarge): $251 T-Shirt (Youth S): $251 T-Shirt (Youth M): $251 T-Shirt (Youth L): $251 T-Shirt (Small): $251 T-Shirt (Medium): $251 T-Shirt (Large): $251 T-Shirt (XLarge): $25Monthly Tuition: Price: $ 0.00 CAD TotalUp Front Payment (Paid today) Price: $ 0.00 CAD Monthly Payment (Billed the 15th of every month for 9 months starting Sep 15) Price: $ 0.00 CAD Total Price: $ 0.00 CAD This field is hidden when viewing the formSubscription Start Date Month Day Year Billing InformationBilling Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit CardCard Details Cardholder Name -PhoneThis field is for validation purposes and should be left unchanged.
