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Student Admission Form
Please fill out the form below to apply for admission. Fields marked with
*
are required.
Student Information
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Gender
*
Male
Female
Grade Applying For
*
---------
Kindergarten 1
Kindergarten 2
Kindergarten 3
Grade 1
Grade 2
Grade 3
Grade 4
Current School (if applicable)
Student Photo
Upload a recent passport-sized photo
Parent/Guardian 1 Information
Full Name
*
Relationship to Student
*
Phone
*
Email
*
Employment Status
---------
Employed
Self Employed
Unemployed
Retired
Employer
Address
Parent/Guardian 2 Information
Full Name
Relationship to Student
Phone
Email
Employment Status
---------
Employed
Self Employed
Unemployed
Retired
Employer
Address
Emergency Contact (Other than Parents)
Full Name
*
Relationship to Student
*
Phone
*
Email
Address
Medical Information
Medical Conditions
Please list any medical conditions we should be aware of
Allergies
Please list any allergies (food, medication, etc.)
Medical Document
Upload any relevant medical documents (PDF, JPG, PNG)
Additional Information
Additional Notes
Any other information you'd like to share with us
Submit Application