APPLICATION FORM - Casa dei Bambini (Broadrick Road Campus)

CASA dei BAMBINI - THE PRE-PRIMARY SCHOOL PROGRAMME

(Broadrick Road)

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CHILD'S PARTICULARS
Please upload a recent picture of the applicant, thank you.*

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Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Gender*

MaleFemale
RESIDENTIAL STATUS IN SINGAPORE*

SingaporeanSingapore PRForeigner
BIRTH CERTIFICATE / FIN / PASSPORT*

Birth CertificateFINPASSPORT
Number *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Preferred Commencement Date*

DayMonthYear
Please refer to our calendar
PARTICULARS OF PARENT/S OR LEGAL GUARDIAN
Mother's Name*

First NameLast Name
Mother's NRIC / FIN / PASSPORT*

NRICFINPASSPORT
NUMBER*
Mother's Mobile Number*

Country CodePhone Number
Home Number

Country CodePhone Number
Office Number

Country CodePhone Number
Mother's Email*
example@example.com
Father's Name*

First NameLast Name
Father's NRIC / FIN / PASSPORT*

NRICFINPASSPORT
Number*
Father's Mobile Number*

Country CodePhone Number
Home Number

Country CodePhone Number
Office Number

Country CodePhone Number
Father's Email*
example@example.com
Guardian - Phone Number

Country CodePhone Number
Office Number

Country CodePhone Number
IN CASE OF EMERGENCY, PLEASE CONTACT:

(PLEASE NOMINATE A PERSON NOT LIVING WITH YOU)
Name*

First NameLast Name
NRIC / PASSPORT OR FIN Number*
Last 4 characters
Mobile Number*

Country CodePhone Number
Contact's Email*
example@example.com
RELATIONSHIP TO APPLICANT: *
EDUCATIONAL DETAILS
HAS YOUR CHILD ATTENDED SCHOOL BEFORE?

YesNo
WAS IT IN A MONTESSORI ENVIRONMENT?

YesNoN/A
REFERRALS AVAILABLE ?

YesNo
Application Fees: $288 (non-refundable)

If you are drawing a cheque, please make it out to MFC Kindergarten II ( Broadrick Road).

Should you wish to make a transfer, we append our bank account information for your attention:

Name of Bank: DBS Bank
Branch: Towner Road
Account Name: MFC Kindergarten II (Broadrick Road)
Account No: 028-009573-2
Type of Account: Current Account

- I understand that this application, if accepted, is not a guarantee, for obtaining a placement nor a placement by requested enrolment date;- I understand that my child may be offered a morning (8.15 – 11.15) or afternoon (12.30 – 3.30) the session, depending on the waiting list at MFC Kindergarten and the position of my application on that the list, subject to the condition below;

- I understand that the fee paid is not refundable unless my application is rejected, in which the case I am eligible for a refund of $288.00 not later than 30 days from my application being received at MFC Kindergarten.
NAME OF PERSON SUBMITTING APPLICATION*

First NameLast Name
RELATIONSHIP TO APPLICANT*
DATE*

DayMonthYear
Date
FOR OFFICE USE ONLY
MFC/BR/
DATE: Date
BANK TRANSFER/CHEQUE/CASH
Should be Empty:

IN CASE OF EMERGENCY, PLEASE CONTACT: