Class Applied For --Select-- ReceptionYear 1Year 2 Year 3Year 4Year 5 Year 6Year 7Year 8 Year 9Year 10Year 11 Date of Application Family Name Given Name(s) Date of Birth Gender Country of Birth Nationality Religion English Language Proficiency Spoken fluently Spoken with difficulty Not spoken

Previous School 1 From To Previous School 2 From To Date of Entry Siblings in School Special Educational Needs? --Select-- YES NO

Parent/Guardian 1 (Father)

Full Name Nationality Occupation Employer

Parent/Guardian 2 (Mother)

Full Name Nationality Occupation Employer

Postal Address Residential Address Father's Work Phone Mother's Work Phone Emergency Contact Email Who will pay the fees? --Select-- Ourselves Totally Employer Totally Other If Employer or Other, Please Specify

School Report Attached? --Select-- YESNO Transfer Letter Attached? --Select-- YESNO Special Needs Report Attached? --Select-- YESNO Upload School Report (PDF): Upload Transfer Letter (PDF): Upload Special Needs Report (PDF):

Health Declaration Form

Family Name Given Name(s) Doctor's Name Doctor's Address Do you have any allergies? --Select-- YESNO If YES, please specify Any special learning needs? --Select-- YESNO If YES, please specify Other medical conditions Regular medications

Declaration by Parent/Guardian

I/we hereby accept full responsibility for the payment of school fees and declare that all information provided is correct. Material inaccuracies may result in admission review.

Signature (Father) Signature (Mother) Date