Fairmont Student Application Form
Fairmont High School Mukono
Personal Information
Section A: Provide your personal details below.
Full Name
*
First Name
Last Name
Email Address
example@example.com
Gender
*
Male
Female
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Nationality
*
Class
*
Please Select
S.1
S.2
S.3
S.4
S.5
S.6
Religion
*
Academic Background
Section B: Provide your academic history and examination results.
Former Primary/Secondary School
*
Index Number
*
Year you sat for PLE/UCE
*
PLE/UCE Aggregates
*
Have you attended any other secondary school before?
Yes
No
Which academic level are you applying for?
*
O Level
A Level
Parent/Guardian Information
Section C: Fill in your parent or guardian's details.
Father's Name
*
Father's Occupation
*
Father's Place of Work
*
Mother's Name
*
Mother's Occupation
*
Mother's Place of Work
*
Parents' Telephone Contacts
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Person/Organization that pays your fees
*
Has any of your siblings been a student at Bugema Adventist Secondary School? If yes, mention their names.
Co-curricular Activities
Section D: Indicate your participation in co-curricular activities.
Indicate the co-curricular activities you participated in
*
Attach PLE/UCE/any other relevant documents (pictures or documents)
*
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