Sign Up NowRegistration Form

    Parent's Declaration:

    Parent's Name:

    Email Address:

    NRIC:

    Nationality:

    I wish to register my child for the Student Care Centre at:

     I declare that, to the best of my knowledge, all information given below is true.

     

    Student's Particulars:

    Name of Student:

    Age:

    Gender:

    Class:

    School Attending:

    Address:

    Telephone Number:

    Nationality:

    Birth Cert No. :

    Birth Date:

    Medical History & Allergies:

     

    Parents' Particulars:

    Father's Name:

    Age:

    Occupation:

    Race:

    Religion (if any):

    Gross Monthly Income:

    Office Number:

    Mobile Number:

     

    Mother's Name:

    Age:

    Occupation:

    Race:

    Religion (if any):

    Gross Monthly Income:

    Office Number:

    Mobile Number:

    Total Gross Income:

     

    Other Family Members:

    Names of Other Family Members Staying in Home:

    Relationship to Student:

    Occupation:

    Remarks:

    Names of Other Family Members Staying in Home:

    Relationship to Student:

    Occupation:

    Remarks:

     

    Type of Home:

     

     

    Particulars of Person to Pick Up Student:

    Name:

    Relationship to Student:

    Mobile Number:

    Home Number:

     

    Other Remarks: