Application Form

Section 1: Student Details

Your id picture

Your passport

Your insurance card

Name (as shown in passport)

First Name (required)

Last Name (required)

Other Name

Date of Birth

GenderMF

Place of Birth

Nationality

Current/Former School

School name

School Address

School Country

Grade

Personal details

Native Language

Other languages spoken

Home phone

Address

Email

Section 2: Program of Choice

K12a. Kindergartenb. Middle Schoolc. High School

Teaching language (Dutch offered as a subject)a. Englishb. Spanish

Section 3: Student particulars

Student's strengths

Student's interests

Will the student need bus transportation?a. Yesb. No

Student's religiona. Adventistb. Baptistc. Catholicd. Protestante. Jehovah Witnessf. Mormong. Pentecostalh. Buddhisti. Jewishj. Hinduistk. Other

If specified above, other religion

AAA is a Protestant Christian School of the Seventh-day Adventist Church. Would you like to participate in religious activities at the school?a. Yesb. No

To your knowledge, does your child have any Special Educational Needs (SEN)?a. Yesb. No

Section 4: Family Details

Note: Details of primary parent or guardian must be completed

Primary parent or guardian

Relation:a. Fatherb. Motherc. Male guardiand. Female guardian

First Name (required)

Last Name (required)

Occupation

Email

Work phone

Cell phone

Secondary parent or guardian

Relation:a. Fatherb. Motherc. Male guardiand. Female guardian

First Name (required)

Last Name (required)

Occupation

Email

Work phone

Cell phone

Emergency Contact

First Name (required)

Last Name (required)

Relationshipa. Familyb. Friendc. Neighbourd. Colleague

I have completed this form truthfully and accurately.