Everest International School, Japan
Please fill in the details.
High Goals for Education
New Student Admission Application Form
Name of the Student *
Your answer
Grade of Enrollment *
Your answer
Visa Status *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Your answer
Gender *
Blood Group
Nationality *
Address Details in Japan
Prefecture *
Ward/City *
Example: Suginami - Ku
Your answer
PO BOX Number *
Example: 1670051
Your answer
District/Place *
Example: Ogikubo
Your answer
Street Address *
Example: 2-3-4
Your answer
Building Name
Example: EISJ Building
Your answer
Room Number *
Example: 203
Your answer
Address in Nepal
Province *
District *
Your answer
Municipality *
Your answer
Street Address *
Your answer
House Number
Your answer
English Language Skills of the Student
Read
Write
Speak
Understand
Guardian's Information
Father' Name *
Your answer
Father' Contact Number *
Your answer
Mother' Name *
Your answer
Mother' Contact Number *
Your answer
Emergency Contact Information
This information should be other than that of the guardian's.
Emergency Contact Name *
Your answer
Emergency Contact Person' Phone Number *
Your answer
Relationship with the Student *
Academic Background of the Student
Previous (Last) School' Name
Your answer
Grade Completed
Your answer
Medical History of the Student
Has your child been treated for any serious medical issue in the past? *
If yes, please provide the details of the condition.
Your answer
Does your child have any medical problems now? *
If yes, please provide the details of the condition.
Your answer
Name of the applying Guardian *
Your answer
The information provided here are true and correct to my knowledge. *
Required
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