Note: Fields marked with an asterisk * are required
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PERSONAL INFORMATION:
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Surname* |
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First Name* |
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Middle Name |
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Gender* |
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Date of birth * |
( YYYY/MM/DD) |
Nationality* |
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State * |
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Local Government Area / City* |
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Height* |
(m) |
Body Weight* |
(kg) |
Family Size |
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Position in Family |
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Name of last school Attended |
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Reason for leaving last school attended |
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Class to which admission is sought* |
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Passport * |
Image file must not exceed 1MB
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MEDICAL RECORD:
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Vision* |
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Hearing* |
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Speech* |
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General Vitality* |
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Disability* |
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Genotype |
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Blood Group |
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Other Medical Information |
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PARENT'S INFORMATION:
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One of the parent's information (Either father or mother) must be completed
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Father's Name |
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Father's Occupation |
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Father's Office Address |
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Father's Home Address |
AutoCount
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Father's Phone number(s) |
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Father's Email Address |
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Mother's Name |
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Mother's Occupation |
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Mother's Office Address |
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Mother's Home Address |
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Mother's Phone number(s) |
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Mother's Email Address |
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GUARDIAN'S INFORMATION:
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Guardian's Name |
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Guardian's Occupation |
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Guardian's Office Address |
AutoCount
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Guardian's Home Address |
AutoCount
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Guardian's Phone number(s) |
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Guardian's Email Address |
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PAYMENT RECEIPT UPLOAD
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File must not exceed 2MB [Word/Pdf file types only]
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