| AF #. _____________ |
Date: _________________________ |
|
| Student Data |
| Name: |
______________________________________ |
| Date Of Birth: |
________________ |
| Nationality: |
________________ |
| Mother Tongue: |
____________________________ |
| Language(s) Spoken: |
______________________________________ |
| Recent Photograph |
|
| Family: |
|
| Father: |
________________________________ ___________________________ |
| Mother: |
________________________________ ___________________________ |
| Guardian: |
________________________________ ___________________________ |
| Brother(s): |
Age |
| 1. |
______________ |
| 2. |
______________ |
| School: |
_________________________________________ |
| Sister(s): |
Age |
| 1. |
______________ |
| 2. |
______________ |
| School: |
_________________________________________ |
| Family Address: |
|
| Telephone: |
__________________________ |
| Email: |
__________________________ |
| Other Student Information |
| 1. Previous Illness/allergy, if any |
a.
b.
c. |
| 2. Special Dietary Restrictions, if any. |
| |
| 3. Have all routine immunizations been given? |
| Yes No |
| 4. Any previous school attended Name // Year |
| a)______________________________________________ //___________________ |
|
| Office Use: |
Recd Date ________________________________
Recd By __________________________________ |
