Elementary School Application (Ages 6-10 years) Application Code * Click here to get application code! Name of Student * First Middle Last Sex * Male Female Father's Name * First Last Title * Mr. Mrs. Engr. Dr. Prof. Mother's Name * First Last Title * Mr. Mrs. Engr. Dr. Prof. Address * Phone No * Age by September this year Date of Birth Name of Last School Attended * Grade Entering at this school (Playing Nursery K4, K5, Grade 1, 2, 3, 4, 5: Emergency Phone if parents cannot be reached: If parents are separated or divorced, with whom does the child stay? YOUR CHILD'S HEALTH Please provide us with details about your child's health. For immunizations, tick the ones your child has received and the dates of each. Give name and address of your child’s physician * SECTION B: Information on Parents/Guardian Please provide us with more information on the child's caregiver. Name * First Middle Last Occupation and Designation * Home Address * Phone No * Office Address * Official Phone No (if any) Marital Status * Are you living with your spouse? Please, state the number of children, their ages and sexes * Religion Denomination Please state the address of your worship center * Your designation at the center * Who do we contact in case of an emergency? Name * Home Address * Phone No * Office Address * Official Phone No (if any) Statement of Co-operation In making an application for my child, it is my desire to have him/her complete the school year. It is also my understanding that the policy of the school is to make no refund on registration fees. I also give permission for my child to take part in all school activities including sports and school-sponsored trips away from school premises. Parent/Guardians Name Phone Number Email Address Comments
