PUPIL’S REGISTRATION FORM – Musafiriina Islamic Nursery and Primary School

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Pupil's Registration Form

Together we create a loving community of purposeful learning that focuses on the whole child, body, Mind, and spirit.

A. PERSONAL INFORMATION

Surname / family name:

First Name:

Class:

Age:

Date of birth:

Gender:

MaleFemale

Nationality:

Religion:

Year of application:

Year of admission:

Term:

Current place of residence:

B. POSTAL ADDRESS

Town / City:

Street / RD:

Tel (Residence):

Father’s full name / Guardian:

Tel:

Place of work:

Mother’s full name:

Tel:

Next of kin:

Tel:

Street / Road:

Place of work:

C. ANY BROTHER(S) OR SISTER(S) IN THIS CENTRE

Name(s) and Class(es):

D. FORMER SCHOOL

Name(s) and Class(es) and Year(s):

MEDICAL INFORMATION

Does your child suffer from any of the following (No / Yes / Severe / Moderate / Mild):

Does He / She require medical treatment (No / Yes):

Other conditions:

Does your child take regular medication and dosage:

DECLARATION (TO BE SIGNED BY PARENT / GUARDIAN)

We declare that the information supplied and accompanying documents are, to the best of our knowledge, true and correct:

Parent / Guardian Name (in BLOCK LETTERS):

Date:

Pupil's Registration Form

A. PERSONAL INFORMATION

B. POSTAL ADDRESS

C. ANY BROTHER(S) OR SISTER(S) IN THIS CENTRE

D. FORMER SCHOOL

MEDICAL INFORMATION

DECLARATION (TO BE SIGNED BY PARENT / GUARDIAN)

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