Enrolment -


Enrolment Information
Day
Month
Year
The student's academic year level at entry
The student's previous school name
Student Details

First name
Middle name/s
Last name

Please enter your legan name as it appears on your Birth Certificate.

First name
Middle name/s
Last name
Day
Month
Year
Select gender
Primary Residence *

Please enter the primary residence

Primary Caregiver 1

e.g. Mother's name
e.g. dsmith@gmail.com
e.g. 022 575 2627
e.g. 0 575 2627
e.g. 0 575 2627
Relationship to the student

Primary Caregiver 2

e.g. Father's name
e.g. bsmith@gmail.com
e.g. 022 575 2627
e.g. 0 575 2627
e.g. 0 575 2627
Relationship to the student
Please tick if the student resides at another address at times
Health Details

List any medical problems the school should be aware of, incuding hearing, allergies and diagnosed conditions
Special abilities, disability or learning difficulties
Emergency Contact

Contact 1
e.g. 0 575 2627
e.g. 021 575 2627
Contact 2
e.g. 0 575 2627
e.g. 027 575 2627
Special Interests