Shungu's Wisdom English Medium School
2025 Application Form
Student Information
Name
*
First Name
Last Name
Grade
*
School Last Attended
Gender
*
Please Select
Male
Female
N/A
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Physical Address
*
Email
example@example.com
Parent(s)/Guardian(s) Information
Please list in order of whom to contact first
*
Emergency Information
Name
First Name
Last Name
Relationship
Phone Number
-
Area Code
Phone Number
Can this child take part in regular physical activities?
Yes
No
Do you want to indicate any related information?
Date of Registration
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Save
Submit
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