Student Application
Name in Full:
Your answer
Date of Birth
MM
/
DD
/
YYYY
Age:
Your answer
Birth Place:
Your answer
Gender:
Ethnicity:
Your answer
Passport Number
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Date of Entry:
MM
/
DD
/
YYYY
Grade to be Entered:
Local Address
Your answer
Identifying Landmarks
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Student Lives with:
FATHER’S INFORMATION
Father’s Name:
Your answer
Father's Occupation:
Your answer
Fathers's Nationality:
Your answer
Father's Volunteer Interests:
Your answer
Father's Postal Address:
Your answer
Father's Home Phone:
Your answer
Father's Work Phone:
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Father's Mobile Phone:
Your answer
Father's Employer:
Your answer
Father's e-mail:
Your answer
MOTHER’S INFORMATION
Mother’s Name:
Your answer
Mother’s Occupation:
Your answer
Mother’s Nationality:
Your answer
Mother’s Volunteer Interests:
Your answer
Mother’s Postal Address:
Your answer
Mother’s Home Phone:
Your answer
Mother’s Work Phone:
Your answer
Mother’s Mobile Phone:
Your answer
Mother’s Employer:
Your answer
Mother’s E-mail:
Your answer
Emergency contact
Emergency contact's Name
Your answer
Relationship
Your answer
Emergency contact's Home Number
Your answer
Emergency contact's Work number
Your answer
Emergency contact's Mobile number
Your answer
Overseas Contact (if applicable)
Overseas Contact's Name
Your answer
Overseas Contact's Address
Your answer
Overseas Contact's Country
Your answer
Overseas Contact's Phone
Your answer
Overseas Contact's e-mail
Your answer
Siblings
PREVIOUS SCHOOL EXPERIENCE, if applicable (three most recent):
Name of school (1):
Your answer
Address of school(1):
Your answer
Grades Attended the school(1)
Your answer
Name of school(2):
Your answer
Address of school(2):
Your answer
Grades Attended at school (2)
Your answer
Name of school(3):
Your answer
Address of school(3):
Your answer
Grades Attended at the school (3)
Your answer
Has this child ever been suspended or expelled from school?
When
MM
/
DD
/
YYYY
Why?
Your answer
Has your child been involved in any special testing?
Has your child had special classes/ tutoring?
Has your child had academic difficulties?
Has your child been referred for psychological counselling or testing?
REFERENCES: (Within Uganda when possible)
Referee's Name(1)
Your answer
Referee's Address(1)
Your answer
Referee's Name(2)
Your answer
Referee's Address(2)
Your answer
How many years has student studied in an English as a first language School?
Your answer
Describe English language proficiency:
Other languages spoken:
Your answer
Other languages written:
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I declare that the above information is correct. I permit my child’s full participation in all the activities, including religious instruction, which the school includes in its curriculum. I have read and agree to the guidelines in the Parent-Student Handbook.
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