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Jalyn Application Form

Note: All fields marked with astericks (*)are Mandatory.

Having read the rules and regulations of the school. I wish to make an application for my child / children in: (*)
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In Class
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Date
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PARTICULARS OF THE CHILD.

Surname (*)
Enter the Surname.
Other Names (*)
Enter Other Names
Date of Birth (*)
Enter date of birth
Last School Attended
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Class at present
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Religion (*)
Enter your religion
Email Address (*)
Enter a valid email address.

PARTICULARS OF PARENT / GUARDIANS.

Mother Name / Guardian
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Nationality
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Occupation
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Employer
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Address
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Tel (Office)
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ID NO
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Father Name / Guardian
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Nationality
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Occupation
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Employer
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Address
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Tel (Office)
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ID NO
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Next of Kin
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Tel
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Residence (Estate and House No.)
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CHILD’S DATA

Allergies (or any challenges) e.g. Food, drugs etc
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Hospitals or reference e.g Gertrude Children Hospital etc.
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I agree to have my child taken to any hospital (if need be) of the schools choice.

NB:

Children suffering from infections disease will be excluded from school until certifies fit by the doctor as per public health policy. Sick children should be nursed at home until they have recovered.

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