ONLINE APPLICATION – Kids Palace School

(Please fill out this form neatly with blue or black ink with all required information)

Surname *

First Name *

Other Name(s)

Date of Birth *

Gender *

Nationality *

Religion

Mother Tongue *

Name of Previous School (if any)

Previous/Present Class *

Physical Problems/Disabilities (if any)

Name of Father/Guardian *

Residential Address *

Phone Number *

Level of Education:

Occupation

Relation to Pupil

Name of Mother/Guardian

Residential Address

Phone Number

Email *

Level of Education

Occupation

Relation to Pupil

Any third relative who could pick the child in absence of parents (must be 17 years or above)

Name *

First

Last

Any third relative who could pick the child in absence of parents (must be 17 years or above)

Phone Number

A. Blood Group *

E.g. A+

B. Genotype

C. Underlined Sickness

D. Allergies