Kent International Academy enrollment form

Kent International Academy - San Antonio

Welcome to KIA, school member of Kent Grupo Educativo; the time your child spends with us will be full of great moments and positive learning. We feel that it is essential for children to enjoy their school life and prepare for what comes next. Instructions: fill the form completing all the fields; if any doesn't correspond to your child's information, please type NA and proceed to the next field. Don´t save until you are ready to send.

Child Information

Información del niño (a)
School year *
eg. 2018-19
Choose one or more programs for your child

infant care 1-12 motoddler A 13-23 motoddler B 24-36 mopreschool 3-4 yrsPrekindergarten 4-5 yrs
Childs name *
Date of birth *

DayMonthYear
upload a picture of your child
use this field to upload your Child picture

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Gender *
Nationality
Current address *

citystate

Zip CodeCountry
Religion

Information about previous school or daycare facility
Previous school*
Program enrolled*
Second language taught*
Date started/fecha de comienzo

DayMonthYear
Date
Date ended

DayMonthYear
Date

Health information
Blood type
Allergies
Name of physician
If medicated mention
mobile phone from physician
Pre existing conditions
Infectious diseases contracted in the past

InfluenzaCovid 19hepatitischickenpoxOther
If your child has been hospitalized in the past, describe reason and date
Can your child participate in physical activities ?
Does your child has any allergies ?

yesno
To what
if yes, describe

Child´s general information

Siblings

	Name	Age	School
Sibling
Sibling
Sibling

Is your child engaged in any sport or art activity?
Will transportation be required ?
Ask for availability
Late afternoon care will be required ?
3:00 PM-6:00PM

Parent information
Marital status *
School communication will be with*
Father`s name *
Father`s occupation*
Fathers educational level*
Mother`s name*
Mother`s occupation*
Mother`s educational level/Nivel educativo de la madre *
Father´s work phone number
Mother`s work phone number
Father´s mobile*
Mother`s mobile*
Fathers email*
Mother`s emai*

Emergency contact information
Is there an emergency contact ?
Full name of the contact
relationship
mobile phone Number
Email
Full address

CityState

Zip Code
person authorized to pick up the child
2nd person authorized to pick up the child
3rd person authorized to pick up the child

Child documents should be up loaded here
Proof of address

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Parent`s proof of identity

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Only of one parent or tutor Cancelof
Child`s birth certificate or other proof of identity

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Immunization record updated

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Acceptance of terms for pre enrollment
Parent´s StatementI have filled the pre-admission form; I understand that I will have to complete my child´s admission paperwork with the following documents to be provided by KIA:
- Authorization for emergency and medical attention
- Health Care professional statement
- A copy of immunization record
- Custody Agreement (if applicable)
- Photograph release permission form
- A signed facility policies and procedures
  Service contract
- The admission fee is $100.00 nonrefundable
Signature

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Date

DayMonthYear
Date
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