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ENROLMENT FORM
CHILD'S INFORMATION
Surname:
First Name:
Other Names:
Date of Birth:
Religious Denomination:
FATHER'S INFORMATION
Surname:
First Name:
Occupation:
Contact Telephone:
MOTHER'S INFORMATION
Surname:
First Name:
Occupation:
Contact Telephone:
If the child does not live with parents, who is the primary care giver?
What is the relationship with child?
Length of Pregnancy:
Type of Delivery:
Does the child take any prescription medicines?
Yes
No
Which ones?
Does the child have any chronic illness? e.g. Diabetes, Asthma, etc
Yes
No
Select any of the following sicknesses if your ward has ever experienced one:
Nose Bleeding
Black Out
Dizziness
Convulsion
Vomiting after meals
Any Special Health Needs?
A month's written notice of withdrawal is required or a month's fees will be charged should shorter notice be given.
NOTE:
Fees must be paid at the school’s mandated bank before school reopens. Parents should pay fees as stated since wards would not be allowed on the school’s campus without their pay- in- slips.
(a)
The school’s mandated bank is The Trust Bank located at the “On the Run” junction, Sakumono.
(b)
Our account number is
000111000059020
(c)
Please submit your pay – in – slip as soon as possible to enable the V.I.S cashier to issue an official receipt.
Date of Entry:
E-mail:
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