Student Information

Child's Details

First Name: *

Middle Name: *

Last Name: *

Date Of Birth: *

Date Of Admission

House

Parents'/Guardian's Names:

Father:

Mother:

Guardian:

Parent / Guardian's Contact Details (Home Address, Tel Number, Email Address)

Address

Telephone (home)

Father's Cellphone

Mother's Cellphone

Guardian's Cellphone

Father's Email Address

Mother Email Address

Guardian Email Address

Parent / Guardian Occupation(Work) Details

Father's Occupation

Father's Work Address

Father's Work Telephone

Mother's Occupation

Mother's Work Address

Mother's Work Telephone

Guardian's Occupation

Guardian's Work Address

Guardian's Work Telephone

Emergency Contact Person

Emergency Contact Person Name

Emergency Contact's Telephone

Emergency Contact's Email

Number of persons living with

Number of Sisters

Number of Brothers

Who does the Child live with? *

Mother only Father only Both parents Guardian

Please state if your child has a medical condition the school Should be aware of

Date of Submission

I Parent/Gaurdian acknowleage the information entered above are correct.