REGISTRATION FORM

Zion Place International School

Student Registration Form

SECTION A: STUDENT INFORMATION

Full Name: Gender: Select Male Female Other Date of Birth: Place of Birth: Nationality: Home Language(s): Proposed Grade/Class: Previous School Attended: Reason for Leaving:

SECTION B: PARENT/GUARDIAN INFORMATION

Father/Guardian

Full Name: Occupation: Mobile: Email:

Mother/Guardian

Full Name: Occupation: Mobile: Email:

SECTION C: EMERGENCY CONTACT

Full Name: Relationship: Contact Number:

SECTION D: MEDICAL INFORMATION

Blood Group: Allergies: Medical Conditions:

SECTION E: DOCUMENTS CHECKLIST

Copy of Birth Certificate Passport-size Photographs (2) Previous School Report Medical/Immunization Record Parent/Guardian ID

SECTION F: DECLARATION

I/We declare that the information provided is true and correct. I/We agree to abide by the rules and regulations of Zion Place International School.