KENYAN NATIONAL CURRICULUM

Application Form

KINDLY COMPLETE ALL SECTIONS OF THE FORM AS ACCURATELY AS POSSIBLE.

                            SECTION 1:        LEARNERS PERSONAL DETAILS (As per Birth Certificate / Passport)

LEARNERS NAME:

First Name

Middle Name

Surname

DATE OF BIRTH:

NATIONALITY:

Date

Month

Year

Country of Citizenship

GENDER:

PHYSICAL ADDRESS:

HAS HE/SHE ATTENDED ANY PREVIOUS SCHOOLS:

IF YES, PLEASE FILL IN THE REQUIRED INFORMATION BELOW:

SCHOOL NAME

CLASS ATTENDED

PERIOD ATTENDED

                            SECTION 3:     APPLICATION & SERVICES DETAILS

ENROLMENT TERM:

SUPPORT SERVICES:

ENTRY LEVEL:

Lower Primary

Upper Primary

Upper Primary

Secondary

Secondary

Is the Learner a sibling to a child already enrolled/enrolling into the school?

                            SECTION 4:     PARENTS PARTICULARS

PARENT 1:

MOBILE NO:  +

First Name

Middle Name

Surname

Email Address

Postal Address

PARENT 2:

MOBILE NO:  +

First Name

Middle Name

Surname

Email Address

Postal Address

I hereby declare that the information provided is true and correct. I request for the admission of my child and I confirm that we shall abide by the rules and regulations as stipulated in the school rules, policies and the directions given by the members of staff.

I understand that admission shall be given to successful candidates and an interview / placement exam may be required in order to process the admission. The management of Viraj International Academy reserves the right of admission whose decision is final and the school is not obligated to disclose the reasons of admittance / rejection.

SUBMIT APPLICATION FORM

                            SECTION 2:     PREVIOUS SCHOOLING HISTORY