Independent School Batam Admission Form

First Name Of Child*
Middle Name Of Child
Last Name Of Child
Gender
Date Of Birth*
Family Tongue*
Passport No.*
Religion
Nationality*
Place Of Birth*
Diplomatic/Dinas/Kitas No.*
Age of Brother or Sister
Previous School
City
Country
Dates Of Attendance
Has your child received any additional educational or Medical support at a previous school?
FATHER
Name*
Nationality*
Diplomatic/Dinas/Kitas No.*
Profession
MOTHER
Name*
Nationality*
Diplomatic/Dinas/Kitas No.*
Profession
BATAM ADDRESS
Address*
Telp.
Fax
Email
PERMANENT ADDRESS
Address
Telp.
Fax
Email
INVOICES TO BE SENT TO:
COMPANY DETAIL
Name
Nature Of Business
Address
Telp.
Fax
By lodging this application I/we commit myself/ourselves to support the school in the achievement of its aims and objectives. This includes an undertaking to wear the uniform and support the social code in all respects. We accept that any offer of placement is conditional on the accuracy of the information provided above. False, inaccurate or misleading information could lead to the child’s withdrawal from school. The following documents must accompany this application
1. Previous school reports which include both educational & character reference.Signed (Parent)
2. Application fee
3. Recent photograph
4. Father’s and Child’s passports.
5. Father’s and child’s Diplomatic/Dinas/Kitas (if available)
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