Registration Form

Pupil's Registration Form

Required *

Passport *

Pupil's Surname *

First Name *

Middle Name

Date of Birth *

Other Names

Sex * Male Female

Guardian/Parent (1) BIO-DATA

Title *

Marital Status *

Relationship to/with Pupil *

Your Surname *

Middle Name *

First Name *

Residential and Email Addresses *

Personal Telephone Number *

Other Phone Number 1 *

Other Phone Number 2

Nationality *

State of Origin *

State of Abode and How Long *

Language Spoken *

Office and Email Addresses *

Office Telephone Number *

Office Other Phone Number *

Office Other Phone Number

GUARDIAN?PARENT (2) BIO-DATA

Title *

Marital Status *

Relationship to/with Pupil *

Your Surname *

Middle Name *

First Name *

Residential and Email Addresses *

Personal Telephone Number *

Other Phone Number 1 *

Other Phone Number 2

Nationality *

State of Origin *

State of Abode and How Long *

Language Spoken *

Office and Email Addresses *

Office Telephone Number *

Office Other Phone Number *

Office Other Phone Number

EMERGENCY CONTACT(s) Two(2) People other than Guardian/Parent(s), we can contact in the event of an unforeseen emergency

Name *

Relationship *

Address *

Phone Number *

Other Phone Number

Name *

Relationship *

Address *

Phone Number *

Other Phone Number

**NOTE:

(1) The School should always be instructed-in-writingby Guardian.Parent(s) to effect changes on the above Bio-data when family-circumsatances changes, (e.g marital status, bereavement, filial relationship,etc)

(2) The School should be also be instructed-in-writing with possibly photo enclosed by Guardian/Parent(s) of any particular person(s) apart from the contact-Names mentioned above, for which the Pupil SHOULD/SHOULD-NOT we whilst within the School premises

MEDICAL HISTORY CONDITION(s)
Please give family-Doctor's data and indicate any allergies, disabilities, major-illness(es), health-crises, hearing/sight loss, etc

Medical History *

Name of Family Doctor *

Address Of Doctor's Clinic/Hospital *

Doctor's Telephone Numbers *

Doctor's Other Number

RELIGIOUS & SOCIO-CULTURAL FACTOR(s):
Religious teachings, Diet, Clothing/Dress-Codes etc

Religious & Socio-Cultural Factor(s) *

INDICATE NAMES/ADDRESSES OF LAST TWO (2) SCHOOLS/PLAYGROUPS/NURSERY(IES) PREVIOUSLY ATTENDED BY PUPIL:

Name of Previous/Nursery(ies) *

Previous School/Nursery(ies) Address(es) *

Telephone Number

Other Telephone Number