Application Form

School Application Form

Student Name

Address

City
State
Zip

Date of Birth

Gender
MaleFemale

Nationality
Place of Birth

Name of Previous Schools Attended

Highest Grade Completed

Does the student have any medical conditions?
YesNo

If yes, specify details

Parent / Guardian Details

Parent / Guardian Name (Primary)

Relationship to Student

Email

Preferred Contact Number
Alternative Number

Parent / Guardian Name (Secondary)

Relationship to Student

Email

Preferred Contact Number
Alternative Number

Emergency Contact Person

Emergency Phone Number

School Information

Proposed Start Date

Program

Reason for Choosing Our School

Upload Documents
Birth Certificate
SSN
Valid ID
Immunization Record
HS Diploma / GED

[acceptance* declaration] I confirm that the information provided is accurate and complete. [/acceptance]