Application Form

Student Admission Application Form

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Student Information
Name of student (Surname/middle/ first) *
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Class applied for *
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Admission Number
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Grade *
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Previous School *
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Date of birth (D/M/Y) *
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Place of birth
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Weight (Kgs)
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Height (m)
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Citizenship
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Religion
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Special talent
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Details of the parent/guardian(state relationship if guardian)
Name *
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ID/Passport No *
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Hse No.
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Street
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Estate
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Town
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County
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P.O Box
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HomeTel
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Parent Mobile
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Email
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Occupation
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Employer’s or Business Name
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Address
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Additional (next of kin) contact in case of emergency
Name
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Relationship
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Mobile
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Other phone
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Medical information
Ensure this is accurate and should be confirmed by a medical officer.If the answer to any of the following is Yes,please attach details and your Doctor’s assessment report.
Does the student suffer from an existing medical condition?
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Is the student on any medication, or require regular medication
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Does the student have any medical limitations on participation in any school activities?
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Does the student suffer from any allergies (food types, medicine, etc)
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Any other medical information that the school should know of to best respond to an emergency
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Details of any Medical Cover
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Doctor Information
Family Doctors Name
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Telephone No:
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In case of medical emergency, if the school is unable to reach the parent, guardian, next of kin, or Doctor provided herein, the parent hereby authorises the Headmaster to take any action that he considers in the best interest of the student in the particular circumstances.
   
Financial information
Will the fees and other payments due be made by Parent/Guardian or sponsor? If sponsor, kindly signify below your undertaking to pay the fees due:
Sponsor’s name
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Contact
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Address
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Position
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Telephone
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Any limitations on sponsorship
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Terms and conditions in respect of finances
1. A deposit is payable to secure admission, and if the place is not taken up, upto 10% of the annual fees will be forfeited.
2. Fees shall be paid in full, and in advance of each term, to cover specific costs.
3. Where fees due are not paid, a surcharge may be imposed, which shall be payable.
4. Once paid, fees will not be refunded due to absence of the student from school for whatever reason
5. Whenever a student is withdrawn from the school, without at least one term’s notice, the fees in respect of the term not attended will be due and payable.
6. The school will not be responsible for the safety of personal finances in the person of the student. Such cash, and any items of value, should be deposited with the office for safe custody
   
I/We confirm that I/we have read and understood, and fully agree to be bound by these terms and conditions.
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Attachments Checklist
Please ensure you have attached copies of the following:
Birth certificate
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School leaving certificate
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Results certificate (Exam or previous school)
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Medical Examination Certificate (and additional information if applicable)
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