Christ Church Foundation School

Admission Form A

Instructions:

1. Click the Enable Editing button before you attempt to complete the form.

2. Please complete this form by typing in the space provided or by clicking the appropriate box.

3. Save the document with the name of your child/ward.

4. Email the document as an attachment to documents@ccfs.edu.bb. The subject for the email is Admissions 2018. Enter your child/ward’s name and form in the body of the email.

5. The following are required on Tuesday, July 3, 2018: a recent passport size photograph, Birth or Baptismal certificate, a recent Immunization Certificate and the C.E.E slip.

Section 1: Student’s Information

Complete all of this section

Demographic Information

Surname: Type surname.

First name: Type first name.

Other names: Type other names.

Sex:	Male ☐	Female ☐

Place of birth: Type place of birth.	Nationality: Type nationality.

Date of Birth: Month: Select month.	Day: Select day. Year: Type year.

Identification Number: Type identification number.

Address: Type address.

Type address.

Personality and Sibling Information

Temperament of the child. E.g. shy, outgoing etc. Type temperament.

Extra-curricular activities and hobbies: Type extra-curricular activities.

Positions held at previous school: Type position(s).

Number of children in family: Type no.. Pupil is number Type no. of Type no.

Name of sibling(s) who attended or are attending this school: Type name.

Academic Information

C.E.E. Mark: Type mark.	Essay: Type grade.

Previous School Attended: Type name of school.

Academic progress at previous school: Type academic progress.

Medical Information

Name of Family Doctor: Type name of doctor.

Health of Pupil: Type health.

On medication for prolonged period: Yes ☐ No ☐

Medication which should not be taken: Type medication.

Allergies

Dust etc.Type allergies.

Food etc. Type food.

Asthma: Yes ☐ No ☐ (If yes please state medication in the space below)

Medication: Type medication.

Epilepsy: Yes ☐ No ☐	Heart Condition: Yes ☐ No ☐

Vision Impaired: Yes ☐ No ☐	Hearing Impaired: Yes ☐ No ☐

Other problems: Type other problems.

Previous illness or accidents: Type illness or accidents.

Can pupil participate in games? Yes ☐ No ☐ (If no please state reason in the space below)

Reason: Type reason.

Transportation Information

Means of transportation to school: Type means of transportation.

Transportation difficulties: Type difficulties.

Section 2: Parent/Guardian Information

Provide information for at least two individuals

Mother’s Information

Title: Mrs. ☐	Miss ☐

Surname: Type surname.	First name: Type first name.

Other names: Type address.

Address: Type address.

Type address.

Nationality: Type nationality.

Occupation: Type occupation.

Tel Nos: (H) Type home tel.no. (W) Type work tel.no. (C) Type cell no.

Email Address: Type email address.

Father’s Information

Surname: Type surname.	First name: Type first name.

Other names: Type address.

Address: Type address.

Type address.

Nationality: Type nationality.

Occupation: Type occupation.

Tel Nos: (H) Type home tel.no. (W) Type work tel.no. (C) Type cell no.

Email Address: Type email address.

Guardian’s Information

Title: Mrs. ☐	Miss ☐	Mr. ☐

Surname: Type surname.	First name: Type first name.

Other names: Type address.

Address: Type address.

Type address.

Nationality: Type nationality.

Occupation: Type occupation.

Tel Nos: (H) Type home tel.no. (W) Type work tel.no. (C) Type cell no.

Email Address: Type email address.

Religious Denomination

Parent/Guardian: Type religious denomination.

Student: Type religious denomination.

On accepting this place for my child/ward at the Christ Church Foundation School, I and my child/ward undertake to abide by all the rules and regulations of the school. I furthermore guarantee that I will provide him/her with the necessary uniform, pay the annual charge to the Government Text Loan Scheme- $75.00 AND also pay the Petty Fees - $60.00. Non-nationals fees are $1,080.00 per year, in addition to the Text Book Rental Fees - $150.00 per year and Petty Fees - $60.00 per year.

Sign: _________________________________ Date: _________________________________

Parent/Guardian

The following are required on Tuesday, July 3, 2018: a recent passport size photograph, Birth or Baptismal certificate, a recent Immunization Certificate and the C.E.E slip.

Provision will be made for you to sign and date this document during the orientation session for the First Form students. This must be done in order for the admissions process to be completed.