BISD Student Registration Form

Student Registration Form
Please upload recent picture here.*

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Student Details
Student's Legal Name *

First NameLast Name
Preferred First Name
Date of Birth *

DayMonthYear
Date
MaleFemale
Year on Entry *
Automatic calculation based on date of birth against September.
Enrollment Year *
Anticipated Grade of Entry *
CorporateFamilyCorporate and Family
Home Address of the Student *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country*
Nationality*
Add New Child
Student Details
Please upload recent picture here.

Cancelof
Student's Legal Name

First NameLast Name
Preferred First Name
Date of Birth

DayMonthYear
Date
MaleFemale
Year on Entry
Automatic calculation based on date of birth against September.
Enrollment Year
Anticipated Grade of Entry
CorporateFamilyCorporate and Family
Home Address of the Student

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Country
Nationality
Parent/ Guardian Details
Relationship to Applicant*
MaleFemale
Full Name*

First NameLast Name
Home Address (If different from student’s)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Telephone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Home Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Work Telehone Number
Please enter a valid phone number.Format: (000) 000-0000.
Occupation
Company Name
Add a Parent/Guardian
Parent/ Guardian Details
Relationship to Applicant
MaleFemale
Full Name

First NameLast Name
Home Address (If different from student’s)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Work Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Occupation
Company Name
Who does the applicant live with? *
Emergency Contact Name *

First NameLast Name
Emergency Contact Telephone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Applicant*
Add Emergency Contact
Emergency Contact Name

First NameLast Name
Emergency Contact Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Applicant
Background Details

Academic History
Currently Attending School
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Dates Attended

DayMonthYear
Previous Schools
School Attended
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date Started

DayMonthYear
Date Completed

DayMonthYear
Add School
Previous Schools
School Attended
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date Started

DayMonthYear
Date Completed

DayMonthYear
First Language *
Second Language
BasicBeginnerIntermediateUpper IntermediateAdvancedFluent
Special Educational Needs
YesNo
Please Give Details
YesNo
Please Give Details
Any other comments regarding your child that would help us to support them at school?
Health Information

Medical Needs
YesNo
Please give details
YesNo
Please give details
YesNo
Please give details
I/We agree
I/We agree
I/We agree
Consent and Confirmation
It shall be the sole and absolute responsibility of the student/parent/guardian to ensure that all application forms, completed by or on behalf of the student are entirely accurate and correct. Whilst BISD will use its reasonable endeavours to ensure that all information provided to it is accurately recorded, if the information provided is not complete and accurate, BISD will reserve the right to withdraw the offer of admission and keep any amount paid as a final indemnity for BISD. BISD will not be responsible for any consequences, financial or otherwise, in the event that such circumstances arise. It shall be the responsibility of the student/parent/guardian to immediately notify BISD in writing in the event that the said application form contains any inaccuracies.*

I/We agree
I/We consent to the School (through the Head as the person responsible) obtaining, using and holding “personal data” including “sensitive personal data” such as medical information, to be processed lawfully and fairly in accordance with the Data Protection Laws of the Republic of Senegal, for the purposes of safeguarding and promoting the welfare of our child and ensuring that all relevant legal obligations of the School and ourselves are complied with.*

I/We agree
Should be Empty:

Student Registration Form

Student Details

Student Details

Parent/ Guardian Details

Parent/ Guardian Details

Background Details

Previous Schools

Previous Schools

Special Educational Needs

Health Information

Consent and Confirmation