application for school year 2016 - SVIS

APPLICATION FOR
SCHOOL YEAR 2016
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Dear Parents,
Please find below the required forms for SVIS enrolment for the academic year 2016
FIRST-TIME ENROLMENT
Documents for completion and signature:
1.
2.
3.
4.
5.
6.
7.
Enrolmentform
Studentinformation
Medicalform
Sportsform
Permissiontoleaveschoolpremisesforclasstriporsportsactivities
Authorisationforuseofchild’simage
SVISschoolconductrules
Please provide the following documents :
• Amedicalcertificategrantingyourchild’sparticipationinsports.
• Amedicalcertificatefromyourchild’sprimarydoctorintheeventmedicationistaken
regularly(withmentionofthespecificmedication,thedosageandthelengthof
treatment)
• Schoolbulletins(reportcards)forthepasttwofullyearsofacademicreporting.
• TworecentI.D.photos.
• Aphotocopyofchild’svalidpassportoridentitycard.
Schoolinspriptionfeesarerequiredtofinaliseenrolment(seepage12)
Please send your completed enrolment file via post to the following address :
Sainte Victoire International School, Domaine Sainte Victoire, 13710 Fuveau
RE-ENROLMENT
For returning students, please indicate any update to the parents’ professional position and complete
the following forms :
1.
2.
3.
4.
5.
6.
Studentinformation
Medicalform
Sportsform
Permissiontoleaveschoolpremisesforclasstriporsportsactivities
Authorisationforuseofchild’simage
SVISConductofBehaviour
Once we have received the completed application, you will be contacted within 10 days regarding
the student’s admission to SVIS. Additionally, an SVIS letter will be sent to you stating school
acceptance or not. Thank you kindly.
Sincerely,
The SVIS Management Team
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PROCEDURE FOR ADMISSION TO
THE INTERNATIONAL BACALAUREATE PROGRAM
The admission of an IB candidate will be determined on the student’s academic ability and whether
his or her scholastic work habits and attitude will allow him or her to succeed the rigorous IB
objectives.
Admission steps are as follows :
1. Initialmeetinganddiscussionbetweenthefamilyandschooldirector.
2. AnEnglishlanguagetest.
3. Receiptofstudentscholasticrecordsincludingbulletins(reportcards)forthecurrent
year,andteacherrecommendationsaddressingstudent’sscholasticperformanceand
motivation.
4. SVISmanagementwillmeetinternallytodiscussthestudent’seligibility.
5. Awrittenletterfromthedirectorwillbesenttothefamilywithnewsofthestudent’s
acceptanceornotwithin5workingdays.
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Enrolment Form
Student Information
Family Name :
First name :
Date of birth :
Place of birth :
City :
Country :
Nationality :
Information
Requested entry grade level:____________________________________________
Mother Language : ________________________________________________
1st additional language ___________________________________________
2nd additional language___________________________________________
Status: day student (with lunch) – full weekly boarding (Monday - Friday) – Fulltime boarding (7 days weekly).
PersonalInformation
Father’s surname______________________________Father’s first name _________________________
Mother’s surname______________________________Mother’s first name ________________________
The legal representative(s) of the child is/are :
Both parents______ The father ______
The mother ______
Other (please specify)
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Address : ___________________________________________________________________
City : ______________________________________________________________________
Country : ______________________________________________________________________
Mobile phone
Father : ____________________________________
Mother : ___________________________________
Email
Father : ______________________________________
Mother : _____________________________________
Signatures
By signing this form, the applicant’s parents
or guardian accept the SVIS general
conditions.
Signed in FUVEAU on following date : ___________________________
School Director : ___________________________
Student : ____________________________
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Student Medical Information
Surname: …………………………….
First name(s): ……………………………………..
M:………
F : ...............
Birth date: ………………………….
ID Photo
Blood type:……………………………
Height (at time of application) :……………………….
Poids (at time of application) : ……………………….
Any allergies to medication:……………………………………………………………………...
Name and contact information of general doctor :……………………………………………………..
……………………………………………………..
As parent or guardian of the above-mentioned child, I authorise school management and teaching staff
concerned with the well-being of my child the following :
• Access to the medical file of my child, strictly for use in case of an emergency.
• To authorise the intervention of an emergency medical team at the closet medical facility in order to
treat my child in case of accident or illness.
• To provide an authoritative decision to a medical emergency team regarding my child (in the case
parents or guardian cannot be reached).
Signature (parent or guardian) __________________________________
Medical history:
Has your child experienced any of the following health issues:
-nutrition or weight YES NO
-sleeplessness YES NO
-social, emotional or behavioural problems YES
-vision, hearing or elocution issues YES NO
-learning difficulty YES NO
-dermotologic problems YES NO
-breathing difficulty or asthma YES NO
-kidney or uro-génital troubles YES NO
-heart problems YES NO
-diabetes YES NO
-epilepsie YES NO
-allergies YES NO
NO
Please provide additional information should you have responded positively to any of the above (intensity
of trouble, frequence of occurance, last episode, necessary care).
Student
Surname:
First Name:
Grade:
In lieu of filling out the following information, you may attach a vaccination history record.
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Childhood illness:
Indicate any contracted illnesses and the date.
-Mumps YES NO …………………
-Scarlet fever OUI NO ……………
-Chicken pox OUI NO ………….
-Diptheria OUI NO ……………….
-Other ……………………………………
-Rubela
YES
-Measles
YES
-Whooping cough YES
-Pneumonia
YES
NO
NO
NO
NO
………………..
………………..
………………..
………………..
Childhood vaccinations:
Child has received the following vaccinations (provide date).
-Tetnus
-MMR
-Hepatitis A
-Diptheria
YES
YES
YES
YES
NO
NO
NO
NO
………………..
.……………….
………………..
………………..
-Tuberculosis
YES NO ………………..
-Whooping coug YES NO ………………..
-Hepatitis B
YES NO ………………..
Additional questions:
Has the child ever been hospitalised for a medical intervention?
YES NO
If so, please elaborate. Are there any ongoing consequences?
………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………
……………………………………………………………………………………….
Does the child take any occasional or regular medication?
YES NO
If so, which medication and how often?
………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………
……………………………………………………………………………………….
If your child is to take medication during school hours, we require a medical certificate stating the name of
the medication, the length of treatment, the dosage and molecular structure (for foreign students).
Child’s name : ……………………………………………………………………………………………………………
•
Is currently in good health
YES NO
•
Is currently being treated for the following (complete below) :
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………
Authorisation for Medical Intervention
I (name), ……………………………………………… father/ mother/ guardian of (child’s name)
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………………………………………. authorise Sainte Victoire International School to give my
son/daughter any urgent medical care or intervention as deemed necessary, notably if SVIS
management is unable to reach the parents or guardian and urgent medical attention is required.
Date : _________________________
Signature : _________________________
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Authorisation to Leave School
1) Authorisation to leave the school premises: (museum visits, culturel and sporting activities)
I (name), ……………………………………………… father/ mother/ guardian of (child’s name)
………………………………………., authorise Sainte Victoire International School to accompany my
son/daughter on off-premise educational activities during school hours.
Date :
Signature :
2) For Boarders:
The student may return at the end Sunday afternoon, or Monday morning, and may leave school
following the last period on Friday.
I (name), …………………………………….…………….father/ mother/ guardian of (child’s name)
…………………………………………….authorise the following two individuals to drop off or pick
up my child should I be unable to do so :
1. _______________________________________ (relationship)
2. _______________________________________ (relationship)
Date :
Signature :
3) For day students :
(School is open from 8 :30 am to 6 :00 pm, with the exception of Wednesday hours : 8:30 to 12 :30 pm
I (name), ……………………………………………………father/ mother/ guardian of child (child’s
name) ……………………………………… authorise:
-my son or daughter to be dropped off or picked up by the following two individuals.
1. _______________________________________ (relationship)
2. _______________________________________ (relationship)
-my son or daughter to depart school at the end of the day on his/her own.
Date :
Signature :
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IMAGE RIGHTS
I(name):.........................................................................................................................
Residingat:..................................................................................................................
Authorise the school to take and use photographs for publications in which my child may appear.
Thisauthorisationincludesprinted,electronic,orvideopurposesforschooluseonly.
IacknowledgethatanyusewillbestrictlyandexclusivelybySainteVictoireInternationalSchool,or
duringspecialeventsorganisedbytheschool.
I further acknowledge that any images use by SVIS will not intrude on my child’s private life nor
endangerorprejudicemychild.
Iacknowledgethattheschoolestablishmentisundervideosurveillanceandthatanycameraimages
takenofmychildmaybeusedbyschoolmanagementorbyauthorisedlegalservicesifnecessary.
Thesevideoimageswillinnowaybeusedinthepublicdomain.
Signature:.................................................Date:..............................................................
Yourcity/country:.................................................................
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ENROLMENTGUIDELINESFORSVIS
SCHOOLYEAR2016-2017
A- ANNUEL FEES
1- SCHOOLANDBOARDINGFEES
For the academic school year, school and boarding fees may be paid in one of the following manners :
¨ Fullpaymentuponoffinalstudentenrolment,receivinga5%discount
¨ Monthlypayment,dueonthe5thofeachmonth
¨ Trimesterpayment,dueonthe5thofthemonthforthecurrenttrimester
Please check the box of the the payment plan you will use.
PLEASE NOTE: Any partial payment will be automatically settled by either an automatic account
debit (you are required to fill out the accompanying bank information), or by the deposit of your
personal check to be given to the accounting department at the beginning of the year.
School fees are as follows for the academic year beginning September 2016 (expressed in Euros):
PRIMARY (ELEMENTARY) SCHOOL
Level / Grade
SVIS Fees
Pre-CP and CP
Kindergarten and
1st Grade
CE1-CE2
2nd and 3rd Grade
CM1-CM2
4th and 5th Grade
9,200
Part-time boarding - Monday through
Friday (in cooperation with our partner
EDEN) during the weekly academic
school year (refer to school calendar)
Full-time boarding – 7 days a
week (in cooperation with our
partner EDEN) during the
weekly academic school year
(refer to school calendar)
9,700
10,200
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MIDDLE AND HIGH SCHOOL
Level / Grade
SVIS Fees
Part-time boarding - Monday through
Friday (in cooperation with our partner
EDEN) during the weekly academic
school year (refer to school calendar)
6ème–4ème
6th, 7th, 8th Grade
3ème-2nd
9th and 10th Grade
1ère-Terminale
11th and 12th
Grade
Full-time boarding – 7 days a
week (in cooperation with our
partner EDEN) during the
weekly academic school year
(refer to school calendar)
11700
7500 €
9950 €
13700
7500 €
9950 €
14700
7500 €
9950 €
INTERNATIONAL BACCALAUREAT.
Level / Grade
SVIS Fees
Part-time boarding - Monday through
Friday (in cooperation with our partner
EDEN) during the weekly academic
school year (refer to school calendar)
Full-time boarding – 7 days a
week (in cooperation with our
partner EDEN) during the
weekly academic school year
(refer to school calendar)
I.B. Programme
1st and 2nd Years
16000
(par
année)
7500 €
9950 €
• A 5% discount will be given on a one-time payment for the full academic year.
• A deposit of 25% of school fees is due at the time of enrolment (the deposit payment will be
applied toward school year fees). Upon receipt of the deposit, the student will have a reserved
place in the I.B. program starting in September 2016.
• IB Exam fees: In additional to tuition, there will be additional fees payable to the International IB
Programme to cover administrative fees for their candidacy.
SPORT STUDIES OPTION
• Golf
• Football (soccer)
Please consult us directly for details on the Sport-Studies option.
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School fees include the following: school lessons during class hours, assisted study time, school books,
use of sports facilities, meals and civil responsibility insurance.
The fees do not include :
•
•
•
•
•
•
•
SVISschooluniform
Privatelessons
Schooltrips(skiweek,specialstudytrips).
Cultural/museumtrips
Healthcosts(doctorvisits,X-rays,pharmacyexpenses)
AdditionaldaysspentonSVIScampus(outsidetheselectedhousingplan)
Additional transportation expenses such as doctor visits, attending driving school,
outingstoparticipateinCAShours,andanytransportationthattakesplaceoutsidethe
scheduled SVIS bus service (please consult our bus schedule which outlines school
[email protected])
Lodging
We have established a partnership with EDEN, and provide on-site duplex full-service student housing.
The services (subject to change) include :
• An evening meal
• Friday evening / Sunday evening transport to/from train station and airport (within scheduled bus
hours)
Laundry:
Laundry service in available for student clothing and sheets, but does not include blankets, comforters,
poly-filled items or coats. The laundry service charge is included in the full-time Sunday-to-Sunday
boarders. The same service is available for Monday-to-Friday boarders for a monthly fee of 150 euros.
A fee of 180 euros will be billed by EDEN for any additional weekend spent at boarding (2 additional
nights). The charge includes transportion, laundry and meals.
A fee of de 80 euros will be billed by EDEN for any additional night spent at boarding (including
weekends and nights outside the scholastic calendar).
Further housing pricing available on request.
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2- Academicbenefits(Prestationsacadémiquesfaisantl’objetd’unforfait).
•
Laprésentationdediplômesautrequebrevetdescollègesoùbaccalauréatferontl’objet
d’une proposition financière dans la mesure où ils sont délivrés par des organismes
privés indépendants qui demandent une participation financière à SVIS. Un devis
préalable faisant état de tous les frais à engager sera proposé aux parents pour
acceptation.
•
Les langues officielles enseignées à l’école sont: Français et Anglais, Espagnol, Italien,
Allemand.
•
Pourl’étuded’unelangueautreuneétudeforfaitairepersonnaliséeseraréalisée.
•
L’uniformeSVISestfacturéforfaitairementlasommede450€TTC.
Conformément aux dispositions du règlement de l’école, le port de l’uniforme est obligatoire.
Tout uniforme complémentaire peut être commandé auprès de SVIS, nous consulter.
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3- Dépôtdegarantie.
Un dépôt de garantie sera demandé aux parents des élèves hébergés sur le domaine au début de l’année
scolaire.
Ce montant vise à couvrir les dépenses complémentaires de l’élève, notamment :
• Argentdepoche
• Consultationsmédicalesoulesfraisdesoins.
• Optionsetleçonsparticulières.
• Achatsdanslescommerces
• Titresdetransports(avion,trainoubus)
• Dégradationsoudétériorationsdematérieldel’école.
Une facture détaillée est établie à la fin de chaque trimestre.
Le montant de ce dépôt est fixé à 500 euros par an et par élève.
Aucune avance ne sera faite par l’école tant que ce montant ne sera pas déposé. Un appel de fonds
complémentaire pourra être réalisé par SVIS si le montant du dépôt de garantie est consommé par l’élève.
4- Inscriptiondéfinitive.
L’inscription de l’élève sera considérée comme définitive lorsque :
• Ledossierd’inscriptioncompletseradéposé.
• UnexemplairesignédesrèglesdecomportementàSVIS.
• Leversementd’unacompte,àvaloirsurlesfraisdescolaritéde25%serapayé.
• Leversementde450eurospourl’achatdel’uniformeSVIS.
• Leversementdesdépôtsdegarantiepourl’écoleetlelogement.
• Lecaséchéantl’autorisationdeprélèvementremplieetsignée.
5- Réinscription.
Toute réinscription devra intervenir avant le 1er mai de l’année scolaire en cours.
Par principe l’école conserve une place à un élève déjà inscrit. Faute d’une information particulière avant
le 1er juillet, l’élève est considéré comme réinscrit pour l’année suivante.
Si la réinscription n’est pas souhaitée, elle doit être nécessairement confirmée par écrit avant le 1er juillet.
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6- SVISBankingCoordinates
RELEVE D'IDENTITE BANCAIRE
Identifiant national de compte bancaire - RIB
Banque
10278
Guichet
07963
N° compte
00020181601
Clé
05
Devise
EUR
CCM AIX CHAPELIERS
Identifiant international de compte bancaire
IBAN (International Bank Account Number)
FR76
1027
8079
6300
0201
8160
Domiciliation
CCM AIX CHAPELIERS
4 PLACE DES CHAPELIERS
13100 AIX EN PROVENCE
Tél : 08-20-88-78-89
Remettez ce relevé à tout organisme ayant besoin de connaître
vos références bancaires pour la domiciliation de vos virements
ou de prélèvements à votre compte. Vous éviterez ainsi des
erreurs ou des retards d'exécution.
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BIC (Bank Identifier Code)
CMCIFR2A
Titulaire du compte (Account Owner)
SAINTE VICTOIRE INTERNATIONAL
SCHOOL
LIEUDIT CHATEAU MAUREL
CHEMIN DE MAUREL
13710 FUVEAU
PARTIE RESERVEE AU DESTINATAIRE DU RELEVE
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B- Financial Provisions
SVIS school management informs you of the following :
• IfthestudentisexpelledfromschoolorshouldparentswithdrawtheirchildfromSVISduring
thecourseofatrimester,thecurrenttrimesterfeewillbepaidinfull.
• ShouldanenrolmentbecanceledeitherafterJuly1storlessthan30dayspriortothestartof
2ndor3rdacademictrimester,thefulltrimesterfeeswillbepaidinfull.
• Alldamageordestructionofschoolpropertycausedbythestudentwillbepaidinfullbythe
parents.
• Anydaythatthestudentspendsatschooloutsideoftheofficialschoolcalendarwillbilledata
rateof80eurosaday.
• The school will not be held responsible for the loss or theft of money, valuable articles
(computers,jewelry,telephones,designerclothing).Asafeisavailabletothestudentsforthe
aboveitems.
• Adherence to the General School Rules, in particular in regard to student behavior, are
expectedofeachSVISstudentaswellasoftheirparentorguardian.
C- Student Visa
A student visa is required only for students who reside outside the European Union.
Should your child require a student visa, all requests to your local administration should be made following
final enrolment of your child at SVIS.
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D- Application Law in regard to your country of residence
French law alone will apply to any incident that may occur while your child is at SVIS, whatever may be
the country of residence of the parents or legal guardian.
The Court of Aix-en-Provence alone will be used to settle any legal matters that may arise should any code
or conduct or school rules be broken.
The French version of this document alone will be used to settle legal matters.
Agreement signed in two original copies :
City :
City :
Date :
Date :
School Signature :
__________________________________
Student Signature
___________________________________
Parent or Guardian Signature
___________________________________
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!
!
Mandat de
prélèvement
SEPA
En signant ce formulaire de mandat, vous autorisez (A)
SAINTE VICTOIRE
INTERNATIONAL SCHOOL
à envoyer des instructions à votre banque pour débiter votre compte, et (B) votre banque à débiter votre compte
conformément aux instructions de
Nom du Créancier
Vous bénéficiez du droit d'être remboursé par votre banque suivant les conditions décrites dans la convention que vous
avez passée avec elle. Une demande de remboursement doit être présentée dans les 8 semaines suivant la date de débit
de votre compte pour un prélèvement autorisé.
Référence unique du mandat :
SVIS SCHOOL FEES
Identifiant créancier SEPA :
FR70ZZZ605291
Débiteur :
Créancier :
Votre Nom
Nom
SAINTE VICTOIRE INTERNATIONAL SCHOOL
Votre Adresse
Adresse
DOMAINE CHATEAU L’ARC
CHEMIN MAUREL
Code postal
Ville
Pays
Code postal
13710
Ville
FUVEAU
Pays
!
IBAN
BIC
Paiement :
Tiers débiteur
Tiers créancier
A:
Le :
Signature :
Récurrent/Répétitif
Ponctuel
Nota : Vos droits concernant le présent mandat sont expliqués dans un document que
vous pouvez obtenir auprès de votre banque.
Veuillez compléter tous les champs du mandat.
Les informations contenues dans le présent mandat sont destinées à n’être utilisées par le créancier que pour la gestion de sa relation avec son client. Elles pourront donner lieu à l’exercice par ce dernier de ses
droits d’oppositions, d’accès et de rectification prévus aux articles 38 et suivants de la loi N°78-17 du 6 janvier 1978 relative à l’informatique, aux fichiers et aux libertés.
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