AVICA Admission Form

Admission Form
Student Information
Full Name of the Student*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Current Grade/Class*
Previous School (if applicable)
Photo of the Student

Cancelof
Parent/Guardian Information
Full Name of Parent/Guardian*

First NameLast Name
Relationship to the Student*
Phone Number*

Country CodeArea CodePhone Number
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Medical History

This field seek to obtain medical history about your child.
Are there any special health challenges your child has that must be considered? Select if applicable*

Vision ImpairmentSkin DisorderNO CHALLENGESBlood DisorderDietary RestrictionOther
If you have selected any of the above or ticked 'Other', please give more information below.
Enquiry Details
Interested Academic Year for Admission
How did you hear about our school?

Word of MouthOnline SearchSocial MediaSchool WebsiteSign boardsOther
If you selected 'Other' please let us know.
Why do you and your child want to attend AVICA?
Please explain in a few words what AVICA means to you and your child.
Are you interested in the schools activities?

YesNo
Are you interested in the school transportation? Please see the Prospectus for current prices.

YesNo
Would you like to schedule a visit to the school?

YesNo
Preferred Date for a School Tour/Visit

MonthDayYear
I testify that,the information provided above is accurate and correct,and hence give Abetfi victory Christmas Academy permission to keep this information.i have also read through the prospectus and agree to adhere to AVICA's policies and regulations.*

AcceptDeny
Signature*

Clear
Please verify that you are human*
Should be Empty:

Admission Form

Student Information

Parent/Guardian Information

Medical History

Enquiry Details