Student Care Registration Form HPPS

Student Care Registration Form
Student's Particulars
Full Name (as per birth certificate)
Child's birth certificate no.
Date of birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Gender
Citizenship
Primary Level
Class
Does your child have special educational needs (SEN)?
If yes, please indicate your child's SEN below.
Leave blank if not applicable.
Full name of second child as per birth certificate. (Leave blank if not applicable)
Second child's birth certificate no.
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender
Primary Level
Class
Does your second child have special educational needs (SEN)?
If yes, please indicate your second child's SEN below.
Leave blank if not applicable.
Full name of third child as per birth certificate. (Leave blank if not applicable)
Third child's birth certificate no.
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender
Primary Level
Class
Does your third child have special educational needs (SEN)?
If yes, please indicate your third child's SEN below.
Leave blank if not applicable.
Full name of fourth child as per birth certificate. (Leave blank if not applicable)
Fourth child's birth certificate no.
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender
Primary Level
Class
Does your fourth child have special educational needs (SEN)?
If yes, please indicate your fourth child's SEN below.
Leave blank if not applicable.
Address
Postal Code
Is your child currently enrolled in a Student Care Centre?
If Yes, please indicate the name of Student Care Centre
Does your child have any food allergy?

Yes, please state:
Mother's Particulars
Mother's Full Name (as per NRIC)
NRIC (last 4 digits)
Citizenship
Home No.
Mobile No.
Marital Status
Marital Status (Others)
Leave blank if not applicable.
Email Address
Photo of NRIC

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Father's Particulars
Father's Full Name (as per NRIC)
NRIC (last 4 digits)
Citizenship
Mobile No.
Marital Status
Marital Status (Others)
Leave blank if not applicable.
Email Address
Photo of NRIC

Cancelof
Are you currently receiving or having applied for Financial Assistance Scheme (FAS) from the school?
Reason for applying for Student Care
Email Address (to receive confirmation email):
Accident Plan
The centre has purchased a basic accident plan for all students in the student care program. However, parents are strongly encouraged to purchase your own accident plan for additional coverage.

Kindly note that SCC teachers are not trained to manage students with serious special educational needs (SEN).
Parent's Handbook

Please read the Parent's Handbook
Declaration
Please tick
Signature for parent's handbook:
Should be Empty:

Student Care Registration Form

Student's Particulars

Mother's Particulars

Father's Particulars

Accident Plan

Parent's Handbook

Declaration