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Student Additional Information
Previous School

(Please fill in chronological order)


From (month/year)

To (month/year)

Add School


Emergency Contact

In case of an accident/illness and both parents cannot be reached please contact *(OTHER THAN PARENTS): *

Add Emergency Contact

Note

It is the responsibility of the parents to inform the school if their child has a contagious illness that may potentially harm other students or staff.
It is the responsibility of the parents to update above information as needed.
Telephone/mobile numbers and email addresses are extremely important.

Immunization Record

Please attach a copy of applicant’s vaccination/immunization papers in PDF format(Used by school nurse)

You could choose to upload if your certificate is more than 1 page.

You could choose to upload if your certificate is more than 1 page

Health Information

I understand that all efforts will be made to contact parents first, emergency contacts second and if neither are available, I hereby give permission for emergency measures to be initiated in the case of accident or sudden illness.

I certify that all of the above information given is correct and complete

Date: Mar 19, 2019