Our House OSC Grades 1-7 Waitlist (ongoing) Survey

1.Child's Full Name(Required.)

2.Child's Date of Birth(Required.)

Date

SuSunday

MoMonday

TuTuesday

WeWednesday

ThThursday

FrFriday

SaSaturday

3.Parent/Guardian Names(Required.)

4.Contact Info (address, phone number, email)(Required.)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

5.Is this child currently enrolled in an MPCCA Childcare program?(Required.)

Our House Out of School Care

Our House Preschool

3 Corners Daycare

6.Do you have another child currently enrolled in an MPCCA Childcare program?(Required.)

Our House Out of School Care

Our House Preschool

3 Corners Daycare

7.Are you currently enrolled at Simon Fraser Elementary School?(Required.)

Yes, registered

No, registered at another school

Waitlisted

Haven't heard yet

8.Are you currently waitlisted to get into Simon Fraser Elementary School?(Required.)

Yes

9.If waitlisted, what number are you on the waitlist?(Required.)

10.Will your child require any additional supports in school or in our OSC Program?(Required.)

Yes

11.If so, please provide some additional information regarding their needs and if there are any resource or practitioners involved in their care for example: BC Centre for Ability, Therapists, Doctors, Care Plans etc.(Required.)

12.MPCCA is committed to providing quality childcare for families with barriers. Does your family identify as a family with barriers? Please select below if yes or select not applicable if no(Required.)

Low Income Family (max net household income of $59,064 for 2 people, $72,338 for 3 people, $83,530 for 4 people, $93,389 for 5 people, $102,302 for 6 people, $110,500 for 7 people) or Receiving Income Assistance.

Child has extra support needs/disabilities and has been identified or received a diagnosis from a medical professional, specialist or by BC Centre for Ability to require them to have 1-1 support in childcare in order for them to remain safe and to thrive.

Single Parent/Guardian Families: Parents/Guardians who have a child(ren) who reside in their home 70% of the time and hold primary (70%) financial responsibility for said child.

Young Parent Families: Be a Canadian Citizen, permanent resident of Canada, conventional refugee or person in need of protection under the age of 25 and have a child that was born on or before the parent's 20th birthday. You must be participating in an education program for the purpose of completing Grade 12 or can provide evidence of low income, enrollment in a government program or government assistance.

Indigenous Families: In acknowledgment and respect of reconciliation and the unseeded lands on which we live and work on, we offer priority to Indigenous Families.

Vulnerability: Based on the non-exhaustive definition of vulnerable families below: families with a parent who has a disability, refugee, families fleeing domestic violence and other under-represented or marginalized groups.

Not applicable

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