Student Registration

1. Personal Information

First Name

First name is required

Middle Name

Last Name

Last name is required

Date of Birth

Date of birth is required

Gender

Gender is required

Nationality

Nationality is required

State of Origin

Local Government

Religion

Blood Group

Languages Spoken at Home

Languages spoken at home is required

Ethnic Background

Form of Identification

ID Number

Image Uploads

ID Photo

Click to upload ID Photo

Max size: 400KB

Profile Image

Click to upload Profile Image

Max size: 400KB

Passport Photo

Click to upload Passport Photo

Max size: 400KB

Previous School

Reason for Leaving Previous School

Special Interests

Student has siblings

2. Contact Information

Address

Street Number

Street number is required

Street Name

Street name is required

City

City is required

State

State is required

Country

Country is required

Postal Code

Postal code is required

Phone Number

Phone number is required

Email Address

Valid email address is required

3. Academic Information

Desired Class

Please select a class

Academic Year

Academic year is required

Admission Date

Admission date is required

Student Type

Student type is required

4. Parent Information

Father Information

Title

First Name

Father's first name is required

Middle Name

Last Name

Father's last name is required

Date of Birth

Gender

Marital Status

Primary Phone

Father's phone number is required

Secondary Phone

Email Address

Father's email is required

Occupation

Employer

Work Phone

Annual Income

Father's Work Address

Street Number

Street Name

City

State

Country

Postal Code

Father's Identification

ID Type

ID Number

Father's Legal Information

Has parental responsibility

Has legal guardianship

Authorised to collect child

Father's Preferences

Preferred Contact Method

Receive newsletters

Receive event notifications

Mother Information

Title

First Name

Mother's first name is required

Middle Name

Last Name

Mother's last name is required

Date of Birth

Gender

Marital Status

Primary Phone

Mother's phone number is required

Secondary Phone

Email Address

Mother's email is required

Occupation

Employer

Work Phone

Annual Income

Mother's Work Address

Street Number

Street Name

City

State

Country

Postal Code

Mother's Identification

ID Type

ID Number

Mother's Legal Information

Has parental responsibility

Has legal guardianship

Authorised to collect child

Mother's Preferences

Preferred Contact Method

Receive newsletters

Receive event notifications

Guardian Information (If Applicable)

First Name

Last Name

Phone Number

Email Address

Occupation

5. Medical Information

General Practitioner

Name

Telephone Number

Address

Medical History

Allergies

Ongoing Medical Conditions

Special Needs

Current Medication

Immunisation Record

Dietary Requirements

Emergency Contact

Name

Emergency contact name is required

Relationship

Relationship is required

Phone Number

Emergency contact phone is required

Email Address

Emergency Contact Address

Street Number

Street Name

City

State

Country

Postal Code

Authorised to collect child from school

6. Special Educational Needs (SEN) Information

Student has special educational needs

Student is receiving additional support

Support Details

Student has an Education, Health and Care Plan (EHCP)

EHCP Details

7. Permissions

I consent to emergency medical treatment

Consent for emergency medical treatment is required

I consent to administration of medication

I consent to first aid treatment

Consent for first aid is required

I consent to student participating in outings and trips

I consent to school transport arrangements

I consent to use of photos/videos for school purposes

I consent to suncream application

I consent to observation and assessment

8. Session Information

Requested Start Date

Requested start date is required

Days of Attendance

Days of attendance is required

Funded Hours

Additional Paid Sessions

Preferred Settling In Sessions

9. Background Information

Previous Childcare Provider

Student's Interests

Toilet Training Status

Comfort Items

Sleep Routine

Behavioural Concerns

Languages Spoken at Home

10. Legal Information

Guardianship Arrangements

Court Orders

Restrictions

Special Circumstances

Parent/Guardian Signature

Signature is required

Signature Date

Signature date is required

11. Funding Information

I agree to pay fees as outlined in the fee structure

Agreement to pay fees is required

Payment Method

Sponsor Details

Sponsor Name

Relationship

Sponsor Contact