Application
Please complete the form below and click submit.
Parent/Guardian Information
First Name
*
Last Name
*
Relationship
*
- Select One -
Mother
Father
Grandmother
Grandfather
Guardian
Joint Custody
Other
Address
*
Email
*
Phone
*
Child Information
First Name
*
Last Name
*
Date of Birth
*
Req. Start Date
*
Location
Langley - City Center
20121 Willowbrook Drive
Langley, BC
V3A 5E6
604 300 8788
Secure Payment
Application Fee
$100.00
Name On Card
Credit Card
Submit
Application Successful
Your application has been received.