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DIA Application Form

Welcome!

Thank you for taking this important step in becoming part of the DIA Community. This application for admission provides us with important information about your child. Please note each child/ren you are enrolling for must have their own application form.

Once the application is submitted, you will be contacted by our Admissions Team who will guide you through the next steps.

If you have any questions, please contact us via email on admissions@diatz.cc or phone on +255 758 828 300.

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Email *
1. General Information
Date of Application
MM
/
DD
/
YYYY
Application for Grade
 *
Expected Date of Enrollment *
MM
/
DD
/
YYYY

Expected length of stay in Dar es Salaam 

2. Student Information 

First Name *
Middle Name
Last Name *
Student’s preferred name (if different from above)
Gender
 *
Date of Birth *
MM
/
DD
/
YYYY
Place of Birth *
Enter city/country
Country of Citizenship *
Passport Number *
Country Issuing Passport
3. A) Family Information
Guardian 1 / Parent 1 (G1/P1)
First Name *
Middle Name
Last Name *
Relationship to Student *
Country of Citizenship *
Languages Spoken *
Preferred Language
Home Address (Physical & Postal)
 *
Home/Mobile Phone *
Employer Information (Company Name/Position) *
Company Phone
Preferred Email *
3. B) Family Information
Guardian 2 / Parent 2 (G2/P2)
First Name *
Middle Name
Last Name *
Relationship to Student *
Country of Citizenship *
Languages Spoken *
Preferred Language *
Home Address  *
Home/Mobile Phone *
Employer Information (Company Name/Position) *
Company Phone *
Preferred Email *
C) SIBLING INFORMATION
List all information about the enrolling child's siblings. Please input N/A if they do not have any siblings.
Name(s) Age(s) *
Currently attending DIA? *
School they are studying at (if not DIA)
 *
4. Student’s Education History
Has your child ever received any special accommodations to reach learning objectives?

a) English as a Second Language
b) Speech Therapy
c) Learning Support (Push in or 1:1)
d) Emotional Support (in the form of counseling)
 *
If YES, please explain in the input box below.
If YES, please explain here.
Has your child ever been suspended or expelled from school?
 *
Is there any further information about your child that will be helpful to DIA? If YES, please explain here.
5. Student Language Profile
Most common language spoken at home *
Is your child able to read and write in above mentioned language?
 *
Other languages spoken
In which of the above languages can your child read and write in?
5.1 ENGLISH
Is your child fluent in English?  *
If No, how long has your child been learning English?
When does your child speak English? (e.g. at school, with friends)
Can your child read and write in English?
Clear selection
How would you rate your child’s English ability?
Clear selection
5.2 FRENCH
Has your child ever studied French? *
If Yes, where and for how many years?
How would you rate your child’s French ability?
Clear selection
5.3 KISWAHILI
Does your child speak Kiswahili? *
How would you rate your child’s Kiswahili ability?
Clear selection
6. Company Information
Guardian 1 / Parent 1 (G1/P1)
Please select the type of company G1/P1 work in
 *
6.1 Company Information
Guardian 2/ Parent 2 (G2/P2)
Please select the type of company G2/P2 work in
Clear selection
7. Billing Information
Please state who you would like all billing information addressed to
 *
Please provide full name/company details required on the invoice
 *
If partial payment by company, please state which percentage each party pays
8. Emergency Contact Information
Must be someone other than the parents/guardians, and located in Dar es Salaam
First Name  *
Family Name  *
Relationship to student *
Phone  *
Preferred Language *
8.1 Emergency Contact Information
Must be someone other than the parents/guardians, and located in Dar es Salaam
First Name  *
Family Name  *
Relationship to student *
Phone  *
Preferred Language *
9. Student Health & Emergency Treatment
Has your child ever suffered from any medical challenges such as (Asthma, epilepsy etc.)?
 *
If YES, please explain. 
Does your child wear glasses or contact lenses?
 *
Does you child have any hearing challenges?
 *
Does your child have any allergies?
 *
If YES, please explain
Are any of these allergies life threatening?
Clear selection
If YES, please explain. 
Do you require the school to keep any medication on hand with the Nurse?
 *
Are there any other health problems that would be helpful for the school to know?
 *
If YES, please explain. 
Does your child take any regular medication? If yes, please explain.
 *
If YES, please explain. 
MEDICAL TREATMENT
Consent required
Please select whether you consent for your child to be attended to by the school nurse or any other trained member of staff if necessary:
 *
The only medication administered at school is Panadol, if needed. Please select whether you consent or do not consent to your child being given Panadol
 *
In the case of an emergency that requires hospital treatment, DIA will take the student to the nearest hospital.
 *
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