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2021-2022 Enrollment

Please complete the enrollment form below then click on the Enroll button to complete the enrollment. Thank you!

First Name*

Middle Name*

Last Name/Surname*

Age*

Date of Birth*

Gender*

Last Class Attended*

Address:*

Is the child handicapped?*

Select an option

Any other medical issues? If yes, please give details*

Select an option

Details

Parent 1 Name*

Occupation*

Address (if different from child's address)

Office Address*

Phone*

Relationship to the child*

Parent 2 Name*

Occupation*

Address (if different from child's address)

Office Address*

Phone*

Relationship to the child*

OFFICIAL USE ONLY:

Admission Number

House

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