THE WORLDHER CHILDREN

THE FUTURE

APPLICATION FOR ADMISSION

Student’s Personal Data

Student’s Educational Background (Please include all school experiences and list the most recent first)

Name of School Type ofCurriculum

From(MM/YY)

To(MM/YY)

LevelCompleted

Language of Instruction

City/Country

Date Application Received:Please attach

passport size photohere

MONT’KIARA INTERNATIONAL SCHOOLNo. 22, Jalan Kiara, Mont’Kiara, 50480 Kuala Lumpur, Malaysia. Tel: +603-2093 8604 • Fax: +603-2093 6045 • E-mail: admissions@mkis.edu.my • Web: www.mkis.edu.my

Family name:

Given name:

Gender: Male Female Nationality: Passport No:

Additional Nationalities: Passport No:

Date of Birth: (DD/MM/YY) Application for Grade:

Intended Date to Start Classes: (MM/YY)

Additional information regarding language(s) of the home:(ie. Child speaks English with siblings, Spanish with mum, Mandarin with dad, Bahasa with the helper)

Residential address while studying at M’KIS:

Telephone number:

ie. Mont’Kiara International School KL, Malaysia English IB August 2009 now Grade Nine

1. Has this student previously submitted an application to M’KIS? Yes / No

If yes, please indicate which school year(s).

2. Has this student ever attended classes at M’KIS? Yes / No

If yes, please indicate which school year(s).

3. If the student has ever received any of the following supports (in and/or out of school)

Please check the appropriate box:

4. Has the student ever repeated a grade Yes / No

If yes, please provide details

5. Has the student ever been asked, advised or required to leave a school? Yes / No

If yes, please state the name of the school and provide details:

Please do submit pertinent information (for example, evaluations/reports) regarding any of the above support services from schools and/or agencies.

Should you have any concerns about the information requested on this page, please email the Head of Admissions (admissions@mkis.edu.my)

Learning Support Reading Support Speech Therapy Counselling

Behavioural Support Occupational Therapy Other

Type of additional support City,Country

From(MM/YY)

To(MM/YY) FrequencySchool and/or

agency nameArea of focus

ie. English classes Exposure tobasic English Private KL August

2016June2017

60 minutes twice a week after school

Please provide additional information:

SPECIAL NOTE

Please complete all sections for both parents and check the appropriate box to indicate relationship:

- Mont’Kiara International School (M’KIS) requires that all students be residing with their parents or a legally court appointed guardian while attending M’KIS.

- The school reserves the right to refuse admission or - if necessary - to suspend the enrolment of students residing with someone other than their parents or legally court-appointed guardian.

- Court documentation in English (or with a certified English translation) is necessary in the case of non-parental guardianship.

Parent’s Personal Data - Mother / Step-Mother / Legal Guardian

Family Name: Given Name:

Nationality: Passport No:

Address (if different from student’s):

Home Tel No: Mobile No:

Personal Email:

Occupation: Nature of Business:

Company Name:

Company Address:

Office Tel No: Work Email:

Parent’s Personal Data - Father / Step-Father / Legal Guardian

Family Name: Given Name:

Nationality: Passport No:

Address (if different from student’s):

Home Tel No: Mobile No:

Personal Email:

Occupation: Nature of Business:

Company Name:

Company Address:

Office Tel No: Work Email:

Should you have questions regarding school fees and billing, please do address them to Ms. Alice Tan (alice@mkis.edu.my), our School Fees Executive. As and when billing information changes, please do let her know.

Signature of father/stepfather/legal guardian: Date:

Signature of mother/stepmother/legal guardian: Date:

1. I/We hereby declare that the information provided in this form is accurate and complete to the best of my/our knowledge. I/We understand that failure to provide complete and accurate information could result in M’KIS, at its discretion, declaring this application or any subsequent acceptance null and void. I/We further understand that should I/ we provide misleading or false information, M’KIS has the absolute right to refuse admission or where admission has been granted, to withdraw such admission, without any claim by me/us for any loss and/or damages suffered or incurred by me/us.

2. I/We recognize that full and accurate information on my child is important for the admission’s staff to properly assess the ability of M’KIS to provide an appropriate educational program. I/We understand that the withholding of records, especially those indicating that my child has special educational needs or handicapping conditions, could result in either the denial of admission or, in the case of my child already having been enrolled, the reversal of the enrollment decision. I/We am/are aware that M’KIS does not provide modified curricular programs.

3. I/We hereby authorize M’KIS to contact any previous schools listed in this form in order to gain more information relevant to the decision to accept this application. Where my child/children has/have already been admitted, I/we hereby authorize M’KIS to contact, from time to time if the situation requires it, any previous schools for additional information.

4. I/We understand that M’KIS reserves the absolute right and discretion to revise the terms and conditions herein from time to time, including any part of the Fee Schedule as it reasonably deems fit. I/We also understand that tuition fees may be increased annually between 8% and 10%. I/We agree to pay fees on time and agree and accept without condition that failure to do so may result in possible exclusion of my/our child attending M’KIS for the new semester.

5. In registering my/our child at M’KIS, I/we agree to conform to the rules and procedures of the school as established by the Board of Governors and the Administration which are set out in the Application Package and/or School Handbooks (a copy of which will be given to my/our child/children or one can be obtained on request from the school office) that may be amended from time to time. I/we hereby agree that I/we have read, understood and agreed to be bound and ensure that my/our child/children be similarly bound, by such rules and procedures. I/We further understand and agree that in the event of I/we and/or my/our child/children failing and/or refusing to observe, comply with or follow such rules and regulations, I/we and/or my/our child/children may be subjected to such action as may be taken by M’KIS as they deem fit and proper pursuant to such rules and regulations and I/we shall not hold M’KIS in any manner liable for the aforesaid action as well as waive all and any rights which I/we may be entitled to or possess as against M’KIS.

6. I/We agree to abide by M’KIS’s Digital Citizenship Agreement (DCA) related to the use of technology.

7. I/We agree that student photographs, images and recordings can be used for school marketing purposes.

8. I/We hereby agree that Middle School/High School students shall participate in M’KIS’s drug testing program (“the Drug Testing Program”) and hereby authorize M’KIS to implement and/or administer the Drug Testing Program from time to time as they deem fit.

9. I/We understand that, once admitted to a particular grade level, promotion to the next grade level is dependent upon the academic success and good behavior of the student.

10. I/We understand that, as a condition for consideration for admission to M’KIS, my/our child may be required to sit for a proficiency test at the sole discretion of the school.

11. I/We hereby give my/our consent, pursuant to the Personal Data Protection Act, 2010, for M’KIS to use and/or process the personal data contained in this form.

12. I/We recognize that the decision of M’KIS regarding the admission of my/our child is final and I/we shall not in any manner hold M’KIS liable in the event my/our child is not admitted and M’KIS is not obliged to provide any reason for the non-admission of my/our child/children.

13. I/We hereby declare that I/we have read and understood the terms and conditions as set out herein and agree to be bound by the same.

Parental / Legal Guardian Agreement

a) My child's school fees will be:

Paid by company

Paid by parents / legal guardian

b) Preferred billing to: Business

Home

Billing address:

For the attention of: