Fairfax Global Academy - Student Application Form

Student Application Form (Grades K-12)

info@fairfaxglobalacademy.com | 703-978-8009
Instructions for filling in the Application Form

All Fields are compulsory. If it is not applicable, please fill as "Not Applicable"

Step 1: Fill in the details
- Enter all relevant details carefully. Once submitted, data can not be changed so please take a look before final submission.
- Have a scanned color copy of the student's photo in jpg/jpeg format available.
- All copies of documents should be self-attested.
- The original transfer certificate from the current school (where applicable) will be retained by the school.
Step 2: Confirmation of Submission
- Press the Submit Button.
- After Successfull Submission of Application Form, you will get a confirmation message on screen.
Student Information
School Year applied for *
eg. 2022-23
Grade or Standard applied for *
Grade 1, Std. 2, etc
Student's Name *

First Name Middle Name Last Name
Date of Birth *

Day Month Year
Gender *
Nationality *
Religion *
For Gov't Reporting Only
Student Pronouns
Student Phone

Area Code Phone Number
Student Email *
example@example.com (It is required that students have their own personal email address. Student email should be different then their parent's email. We will be sending virtual classroom links via email.)
Student Current Address *

Street Address

Street Address Line 2

City State / Province

Zip Code Country
Student Photograph *
Take Photo

Please ensure the following before pressing the submit button
Current School Information
Name of School *
School Contact Name *
Phone Number *
Contact Email Address *
Student's Present Grade or Standard *
Language of Instruction
Date Attended From

Day Month Year
Date
Date AttendedTo

Day Month Year
Date

Student Information (Other)

Sibling Details

	Name	Standard	School
Sibling 1
Sibling 2
Sibling 3
Sibling 4

Sibling 5 and more, please type their names below.
Names
Has the student been double promoted or detained in a standard? If yes, provide details
Has the student been expelled from any School? If yes, provide details
Please mention special talents or abilities that the student possesses.

Parent Information
Parent 1 Name *
Parent 2 Name *
Marital Status *
School Communication should go to *
Parent 1 Occupation *
Parent 2 Occupation *
Parent 1 Education Level *
Parent 2 Education Level *
Parent 1 Work Number
Parent 2 Work Number
Parent 1 Mobile Number *
Parent 2 Mobile Number *
Parent 1 Email Address *
Parent 2 Email Address *
Parent 1 Address *

Street Address

Street Address Line 2

City State / Province

Zip Code
Parent 2 Address (If different from Parent 1's Address)

Street Address

Street Address Line 2

City State / Province

Zip Code

Emergency Contact Information
Name of Emergency Contact Person *
Relationship to Student *
Telephone number *
Email Address *
Address *

Street Address

Street Address Line 2

City State / Province

Zip Code

Acceptance of Terms & Conditions and Declaration of Parents/Guardian
Declaration by Parents/Guardian

We are seeking admission for our daughter/son (hereinafter referred to as Child) in Fairfax Global Academy (hereinafter referred to as FGA) after having read, understood and agreed with the terms and conditions below. We accept them and confirm that our acceptance has not been obtained by any kind of pressure or coercion of any nature whatsoever by the Management of the School.

1. This application has been made by us after having read and understood all the rules of the FGA.
2. We declare that the information furnished by us in this application is true to the best of our knowledge and belief.
3. We fully understand that the admission to the school is based on merit and on availability of a seat at the time of our application and when we are notified for the offer of a placement.
4. We understand that the admission being offered to the child is provisional and the same may be cancelled should any of the statements made in this form is false or the relevant documents are not produced within the 7 days of filing this application unless a different timeline has been agreed up on with the FGA in writing.
5. We fully understand and accept that all fee is required to be paid on or before our child joins the FGA and thereafter each year before the commencement of the Academic Year or as and when demanded before the set due date. We also understand and accept that fees once paid, shall not be refunded under any circumstances by the FGA.
6. In the event of any fee payment is not made on time for its deadline, the Management of the FGA reserves the right to dismiss/de-enroll the child at its discretion and levy any other penalty as it may deem fit.
7. The FGA reserves the right to increase/revise/amend the fee structure and/or the fee to be charged from time to time. These changes could be in line with changes in Government Policies and/or the economic situation (including, but not limited to, inflation, etc.).
8. We understand and accept that the FGA has the right to use our child's photograph for any promotional material, website, social media page/s, unless the same has been expressly objected by parents in writing to the FGA before the commencement of the Academic Year.
9. We understand and accept that our child may be expelled or removed from the FGA for any infringement of the FGA rules of conduct or violating the Honor Code of the school.
10. We understand that the FGA will require our child to create study material and other content from time to time as part of the learning process and that the FGA has the right to retain those materials.
11. We agree that incase of withdrawal of our child from the school, fees for the subsequent quarter will have to be paid.
12. We fully understand and agree that no document other than those required by the FGA will be submitted for admission purposes.
13. By pressing the Submit button, we confirm the above declaration and accept the terms and conditions.
Date

Day Month Year
Date
Signature

Should be Empty:

Student Application Form (Grades K-12)

Student Information

Current School Information

Student Information (Other)

Parent Information

Emergency Contact Information

Acceptance of Terms & Conditions and Declaration of Parents/Guardian