APPLICATION FORM Montessori

Enrolment application for Year 20 _______ September January April STUDENT’S/CHILD’S PARTICULARS FULL NAME OF PUPIL/CHILD: ______________________________________________________________________________ DATE OF BIRTH:___________________________ Age:______ Years GENDER:_____________________________ NATIONALITY:_____________________________ CURRENT/PREVIOUS SCHOOL:__________________________________ Class:____________ Entry level requested at Viraj International Academy: Daisy (2½ yrs – 3yrs) Tulip (3yrs – 4yrs) Orchid ( 4yrs – 5yrs) Reception class (5yrs onwards) PARENTS PARTICULARS FATHER’S NAME:_________________________________________________________________________

MOTHER’S NAME:________________________________________________________________________

RESIDENTIAL ADDRESS: AREA____________________ BUILDING NAME:________________________

POSTAL ADDRESS:_______________________________________________________________________

Father’s Telephone:___________________________ Mother’s Telephone:_________________________

Father’s Email:_______________________________ Mother’s Email: _____________________________

TODAY’S DATE: _____________________________ SIGNATURE: _______________________________ ADMISSION FORMS WILL BE GIVEN TO SUCCESSFUL CANDIDATES AND/OR THE DATE OF THE

INTERVIEW / EXAMS SHALL BE COMMUNICATED TO YOU.

*The management reserves right of admission, whose decision shall be final.

FOR ENQUIRES PLEASE CONTACT: +254 732 822 202, +254 718 822 202, info@viraj.ac.ke

88

First Name Middle Name Surname DD/MM/YYYY 88

Male / Female ___________ Citizen XXXXXXXXXX SCHOOL Year 88

First Name Middle Name Surname First Name Middle Name Surname

Area Name Name Apartments P.O Box 888888-88888, city/town

0788-888888 0788-888888 name@mail.com name@mail.com

DD/MM/YYYY Signed