Student Registration Form

Student Registration Form

STUDENT REGISTRATION FORM

INTAKE 2025/2026
ADDIEN SCHOOL

Lot 201-202, Level 1&2,

Persiaran Stargate Alor Setar,

05400 Alor Setar, Kedah.

addienschool.aiis@gmail.com

019-480 1739
- Full Name
  
  First NameMiddle NameLast Name
- Birth Date
  
  MonthDayYear
- Upload Birth Certificate
  
  Cancelof
- Primary Level
- Email
  example@gmail.com
- Relationship
  ex. Father, Mother, etc.
- Phone Number (Father)
  
  Area CodePhone Number
- Phone Number (Mother)
  
  Area CodePhone Number
- Permanent Address
  
  No Lot/Unit
  
  Street Address
  
  CityState
  
  Postal CodeCountry
- Emergency Contact (Name)
  
  First NameLast Name
- Relationship
  ex. Grandfather, Aunty, etc.
- Phone Number Of Person To Contact In Case Of Emergency
  
  Area CodePhone Number
- School Monthly Fee
- Previous School Name
- Registration Fee RM100 Can be Transfer into Addien Integrated Center, Maybank: 552022690146. Please Attach Proof Of Payment.
  
  Cancelof
- Please verify that you are human
- Should be Empty: