Bloom KKCA Academy Application Form 申請表格

1
Is your child currently enrolled at Bloom KKCA Academy? 學生是否現在就讀百卉九江書院？* This field is required.
Yes 是
No 否
2
Legal Name of Student in English (as shown on Passport/ID) 學生英文姓名 (與證件相同) ：* This field is required.
First Name
Last Name
3
Nickname / Preferred Name 暱稱* This field is required.
N/A if not applicable.
4
Legal Name of Student in Chinese (as shown in Passport/ID) 學生中文姓名 (與證件相同)：
姓
名
5
Identity Document No. (HKID/Passport) 身分證號碼：* This field is required.
6
Nationality 國籍：* This field is required.
7
Place of Birth 出生地：* This field is required.
8
Date of Birth 出生日期：* This field is required.
Day
Month
Year
9
Home Address 住宅地址：* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
10
Home Number 住宅電話：
11
Anticipated Grade Level 入讀級別：
12
Year of Entry (e.g. 2023) 入讀學年：
13
Year of Entry (e.g. 2023/24) 入讀學年：* This field is required.
Please Select
Please Select
2024/25
2025/26
14
Anticipated Grade Level 入讀級別：* This field is required.
Please Select
Please Select
Grade 7
Grade 8
Grade 9
15
If given a choice, which stream would you intended to enrolled in?
DSE
IGCSE / A-Levels
16
Name of Current School 現時就讀學校：* This field is required.
17
Current Grade Level 現時級別：* This field is required.
18
Languages Spoken at Home 在家使用的語言：* This field is required.
19
Number of Siblings in Family 兄弟姐妹人數：* This field is required.
20
You were referred by 推薦人：* This field is required.
21
If you were not referred, how did you hear about us? 如果沒有推薦人，請問您是如何發現我們的？：
Social Media 社交媒體
School Fair 教育博覽
Internet Search Engine 互聯網搜索
Minibus Ad 小巴廣告
22
Name of First Parent/Guardian in English 第一名家長/監護人名稱:* This field is required.
English Name 英文名字
Chinese Name 中文名字
23
Relationship to Applicant 與學生的關係* This field is required.
24
Mobile Number 手提電話：* This field is required.
Country Code
Phone Number
25
Email Address 電郵地址：* This field is required.
example@example.com
26
Occupation (if any) 工作職位:* This field is required.
27
Name of Second Parent/Guardian in English 第二名家長/監護人名稱:* This field is required.
English Name 英文名字
Chinese Name 中文名字
28
Relationship to Applicant 與學生的關係* This field is required.
29
Mobile Number 手提電話:* This field is required.
Country Code
Phone Number
30
Email Address 電郵地址:* This field is required.
example@example.com
31
Occupation (if any) 工作職位:* This field is required.
32
Has your child ever been referred to or received outside services or assessments? 學生是否曾被轉介或接受過專業評估?* This field is required.
Yes 有
No 沒有
33
If yes, please briefly provide details. 如有，請提供詳細資料:
34
Please upload any relevant external reports. All information provided will be kept confidential and used in processing the enrollment only. 所有提供的信息將被保密，僅用於處理註冊。
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
35
Has your child received additional support or extension from school? 學生過去就讀的學校有否曾經提供學習支援或資優課程？* This field is required.
Yes 有
No 沒有
36
If yes, please briefly provide details. 如有，請提供詳細資料:
37
Does your child attend any classes or activities outside of school? 學生有否參加校外的任何課程或課外活動?* This field is required.
Yes
No
38
If yes, please briefly provide details. 如有，請提供詳細資料:
39
1. Tell us about a recent school project or assignment that you really enjoyed. 請述說一份近期完成並享受的功課或專題研習。* This field is required.
0/300
40
2. Contribution to a school community comes in many forms. Please tell us how you see yourself contributing to the Bloom community. 每位學生可以以不同的形式位學校的作出貢獻。請告訴我們您打算如何自己對百卉和同學群組作出貢獻。* This field is required.
0/300
41
Tell us about a creative thing you’ve done recently. 請述說你最近做過的一件有創意的事。
Huge
Large
Normal
Small
Ok
Ok
42
If you had to create a motto to describe your parenting philosophy, what would it be and why? 你有沒有一個和你的培育方針相關的座右銘？你的座右銘會是什麼，並請告訴我們座右銘背後的意味。* This field is required.
Example: “When one door closes, another one opens.” / 「當一道門關閉的時候，另外一道門將會打開。」
43
Please describe your child’s academic strengths and weaknesses. 請描述學生在學業上的強項和弱點。* This field is required.
0/300
44
We want to be able to best support your child academically, socially and emotionally at Bloom. Is there anything we should be aware of to help us better teach and nurture your child? 我們希望學生在百卉度過的時間中都能夠得到適當的學業，社交和情緒支援。為了讓他在學校能夠享受過程，我們對學生還有沒有其他需要注意事項？* This field is required.
0/1500
45
How did you learn about our school, and what influenced your decision to choose our school for your child's education? 家長是怎樣了解到我們學校呢？是什麼原因影響了你選擇我們學校？
Huge
Large
Normal
Small
Ok
Ok
46
Please upload a recent photo of student here. 請上傳一張學生的近期照片。* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
47
Please upload school reports of the past two years. 請上傳學生近兩年的成績單。* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
48
1. I am the parent/guardian of the above-mentioned student.
2. I understand the purpose for which the personal data provided by means of this form will be used and my rights for data access/correction.
3. To the best of my knowledge and belief the information contained in this form is true and correct. If false information is supplied, this application will be rendered null and void.
4. I submit photocopies of all relevant documents (e.g. school report and any other report or referral from outside professional) with this Application Form.

1. 本人為上述申請人的家長／監護人；
2. 本人明白此表格提供的個人資料的用途，和有關查閱及改正資料的權利；
3. 此表格內的資料全屬正確無訛，倘若有虛報資料，則本申請作廢；
4. 本人現隨申請表提交各有關證明文件之副本以供參考
49
I confirm, on behalf of the student, that I would apply for a place at Saint Too Bloom Academy in the following school year. 本人決定為上述申請人申請聖道百卉書院以下學年的學位。* This field is required.
2023-2024
2024-2025
2025-2026
50
Signature of Parent / Guardian 家長／監護人簽署:* This field is required.
Clear
51
Name of Parent / Guardian 家長／監護人姓名: * This field is required.
52
Date 日期:* This field is required.
Date
Day
Month
Year
53
* Information provided will be used in processing the enrollment only. 申請人所提供的資料，只供處理申請時參考之用。

* If you have further questions regarding the application, please contact us at admissions@bloom.edu.hk or call 2311-2268. 如果您有關於申請入學的問題，請發送電子郵件到 admissions@bloom.edu.hk 或致電 2311-2268。
Should be Empty: