Child’s Name:
Child’s Surname:
Child’s Sex:FemaleMale
Date of Birth:
Proposed Date of Entry:
Year:
Is child at least 2.5 yrs? YesNo
Does your child attend a playgroup? YesNo
Which one?:
Address of Parents:
Email address:
Home Language:
Religion:
Name of Parent 1:
Occupation:
Name of Parent 2:
Parent 1 Phone:
Parent 1 Cell:
Parent 2 Phone:
Parent 2 Cell:
State any previous association with the school:
Name and ages of other children in family: