Admission Application for school year -

For entry into (state which class/year group *

Please state your child's current class/year group *

Name (child details) *

Preffered Name *

Sex *GirlBoy

Current Address

Address in Cameroon (if different to above *

Home telephone number *

Date of birth *

Country of birth

Age *

Birth certificate N O *

Cameron CitizenYesNo

If no, please state your child's nationality

If your child has dual nationality, please state which

What is your child's first language? *

What languages are spoken at home? *

Name ( father's details) *

Current Address *

Home number *

Mobile *

Passport/ID number *

Country of issue

Occupation *

Company Name *

Email Address *

Name ( mother's details) *

Current Address *

Home number *

Mobile *

Passport/ID number *

Country of issue

Occupation *

Company Name *

Email Address *

Will both parents be residing in Cameroon while your child is at school here? *

Please state who your child will live with during term time?

Name of sibling

Date of Birth

Day

Month

Year

SexGirlBoy

Name and address of present school

For invoices (please tick):

HomeFather's BusinessMother's Business

Is your child currently attending school? *YesNo

Name and address of last three schools

From (MM/YYYY)

Month

Day

Year

To (MM/YYYY)

Month

Day

Year

Is your child proficient in written and spoken English? *YesNo

Has your child ever been suspended or asked to leave school? If so, please specify. *

Does your child have any physical disabilities, social/learning difficulties or medical problems? (Please include information on depression, anxiety or stress related issues) *

Has your child ever received any form of learning support and/ or has your child ever been assessed by an educational psychologist or any other specialists concerned with child development? (If yes, please specify and provide a copy of the report(s) *

Do you have any general comments about your child that you wish to place on record? e.g. interests / particular achievement?

Date& signature *

Registration N C (For Official Use)

Application fee received

Date of interview with Head of Section/ Headteacher

Head of Section/Headteacher remarks

PlaceofferedNot offered

PlaceacceptedNot accepted

Date of application withdrawn

Reason for withdrawal

Head of Section Signature

Headteacher Signature