Application | SAY Education

Custodianship Intake Form

Please take a moment to fill out the form.

First and Last Name

Phone Number

Citizenship

Date of Birth

Gender

Name and address of school in Canada

Address where student will reside in Canada

Type of residency ? (Homestay, Apartment, Dormitory etc)

Please provide the full name of the person with whom the student will reside (If applicable).

Expected Guardianship Start and End Dates

Please list all medically significant conditions, allergies and/or dietary considerations that either currently or have historically affected the child:

Parent/Guardian #1 Full Legal Names

Parent/Guardian #2 Full Legal Names

Parent/Guardian #1 Date of Birth

Parent/Guardian #2 Date of Birth

Parents/Guardians Phone Numbers

Parents/Guardians Home Address

Parents/Guardians Emails

Any other information for us to know regarding student ?

Thanks for submitting! We will be in touch shortly.