Student Care Centre
Expression Of Interest
IMPORTANT NOTE (Click to expand)
Declaration : (Please read and put a tick accordingly)
I understand that this application form only indicates my interest and does not constitute acceptance into the School-based Student Care Centre (SCC).
I declare that the information given is accurate. Any non-factual declaration will result in this application to be void and forfeiture of a place in the SCC.
I understand that priority is given to Singapore Citizens, and admission to the SCC is a school-based decision, taking into account the needs of the students and the available places in the SCC.
CHILD PARTICULARS (Click to expand)
1. Child's Name (As in Birth Certificate)
*
2. Birth Certificate No.
*
3. Child's Citizenship
*
Singapore Citizen
Singapore Permanent Resident
Other
4. Level in Year 2023
*
Primary 1
Primary 2
Primary 3
Primary 4
Primary 5
Primary 6
CHILD'S INFORMATION (Click to expand)
5. Does your child have any medical condition(s) / Allergies
*
YES (Please specify, at Q6)
NO
6. Medical conditions/allergies (if applicable)
7. Does your child have any special dietary requirement?
*
YES (Please specify, at Q8)
NO
8. Special dietary requirements (if applicable)
9. Does your child have any learning needs?
*
YES (Please specify, at Q10)
NO
10. Learning needs (if applicable)
11. Does your child have any behaviour concerns?
*
YES (Please specify, at Q12)
NO
12. Behaviour concern (if applicable)
13. Are there any other information that you would like to share with us?
YES (Please specify, at Q14)
NO
14. Additional Information (if applicable)
*
PRIMARY AND SECONDARY CONTACT (Click to expand)
15. Primary Contact
*
Father
Mother
Guardian (Please specify at Q16)
16. Guardian Type (only applicable for guardian)
eg Uncle, Aunt, Brother, Sister
17. Primary Contact's Name
*
18. Primary Contact's Nationality
*
19. Marital Status
*
Single
Married
Separated
Divorced
20. Employment Status
*
Employed
Unemployed
21. Primary Contact's Contact No
22. Primary Contact's Email
23. Secondary Contact
Father
Mother
Guardian (Please specify at Q24)
24. Guardian Type (only applicable for guardian)
eg Uncle, Aunt, Brother, Sister
25. Secondary Contact's Name
26. Secondary Contact's Nationality
27. Marital Status
Single
Married
Separated
Divorced
28. Employment Status
Employed
Unemployed
29. Secondary Contact's Contact No
30. Secondary Contact's Email
FAMILY INFORMATION (Click to expand)
31. Family Gross Monthly Income range:
*
Less than $2750
>$2750 to $4000
>$4000 to $6000
>$6000 to $8000
>$8000 to $10,000
More than $10,000
32. Total Number of people living in the same household: (exclude Domestic Helper):
*
33. I have a domestic helper at home.
*
YES
NO
34. My child has another sibling in the Student Care Centre
*
YES
NO
35. Currently my child is looked after by (you can tick more than 1):
*
a family member (i.e. parent/ grandparent/ relative )
a domestic helper
a full-day/ half-day student care centre
Other
36. I have enrolled him/her in an after-school care centre but I'm looking for an alternative.
YES
NO
37. Other comments/information you would like to share: (optional)
Submit
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