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Admission Application Form

Child Information

Full Name (Surname First)

Date of Birth

Gender

Gender
A
B

Home Address

What Class are you applying for?

What Class are you applying for?
A
B
C

Parent/Guardian Information

Priority Contact 1

Title

Full Name

Phone Number

Email Address

Occupation

Relationship to Child

Priority Contact 2

Title

Full Name

Phone Number

Email Address

Occupation

Relationship to Child

Employer Name & Address

Emergency Contact

Full Name

Relationship to Child

Phone Number

Authorized Pick-Up Contacts

Authorized Contact Name

Authorized Contact Phone Number

Medical Information

Allergies

Medical Conditions

Immunization Status

Admission Requirement

Passport photograph of the pupil

Birth certificate

Immunization record

Upload Proof of Application Form Payment

Proof of Payment (Receipt)

Consent & Agreement

Consent & Agreement

Signature & Date

Signature

Today's Date

Reminder: Your application will only be processed once proof of payment of ₦10,000 has been received.