Enrollment Interest Form

Enrollment Interest Form
Student Information
Full Name of the Student

First NameLast Name
Date of Birth

MonthDayYear
Date
Age
Gender
Current Grade/Class
Previous School (if applicable)
Primary language spoken at home:
Parent/Guardian Information
Full Name of Parent/Guardian

First NameLast Name
Relationship to the Student
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has your child ever had a Statement of Special Educational Needs?

YesNo
If yes, does your child have an up to date diagnosis report?

YesNo
Enquiry Details
Interested Academic Year for Admission
How did you hear about our school?

Word of MouthOnline SearchSocial MediaSchool WebsiteOther
Would you like to book an appointment for a school tour?

YesNo
Declaration:

I, the undersigned, confirm that the information provided this Enquiry Form is accurate to the best of my knowledge. I understand that submitting this form does not guarantee admission, and the school will contact me for further details.
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

Student Information