First Name * Last Name *
Date of Birth * Age *
Place of Birth * Gender * MaleFemale
Phone Number * Email *
Emergency Contact First Name * Last Name *
Emergency Phone Number *
City * State/Province *
Postal/Zip Code *
School Year * Grade Level *
School Last Attended *
School Address *
Occupation * Phone Number *
2x Colored ID Picture, Birth certificate, Report card from the previous school, certificate of good moral, and medical clearance.
Upload ID Picture * Upload Birth Certificate *
I agree to terms & conditions provided at the school. I also certify that all information in this form is true and accurate. *
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