*Required Fields
STUDENT INFORMATION
Student's First Name*
Student's Surname*
My child also goes by the name (if other than the given name):
Mailing Address:
PO Box/Bag*
City*
Residential Address:
House Number*
Location*
Home Phone
Age*
Birth Date*
Birth Place*
School last attended (if any)
FAMILY INFORMATION
Father's First Name
Father's Surname
Employment
Position
Work Phone
Cell Phone
Mother's First Name
Mother's Surname
Marital Status* MarriedDivorcedWidowSeparatedSingle
Email of father or mother* (Please enter a valid email address.)
How many siblings does the student have?
What are the ages of the student's siblings?
Please indicate in what order the student falls if you have more than one child.(ex: last child of 3 children or second child of 4 children)
Emergency Contact Name other than parents*
With whom does your child stay? Please indicate name and relationship.*
RELIGIOUS INFORMATION
Students are not discriminated against in any way regarding their religious affiliation.
Church Attending
Pastor's Name
Phone Number
MEDICAL INFORMATION
Clinic Name
Doctor's Name
Does the child have any physical disabilities or allergies or any other medical condition?* YesNo
If yes, please explain.
Has the child received immunisations up to date?* YesNo
Please submit a copy of the child's immunisation record to the Academy office before your child's first day of school, or you may attach it here.
SCHOLASTIC INFORMATION
What special interests does your child have?
Does your child have any academic or social difficulties?*YesNo
If yes, please describe.
Will your child be able to fully participate in physical development activities?* YesNo
If no, please explain.
Why do you want your child to attend Light of the World Academy Preschool?*
Please let us know if you have any additional questions about our school or the enrollment of your child.
PAYMENT INFORMATION
Monthly installments are due on the 1st of each month. Per term installments are due on the first day of school each term. If payment has not been received by the third day (3rd of the month or the third day of the term), the child may not attend school. Late fees apply, according to the Preschool Handbook. If payment has not been received by the end of the month, the child will lose his or her space at Light of the World Academy.
PARENT AGREEMENT STATEMENT
• I pledge to pay my financial obligations on the date due and understand that it may be necessary to withdraw my child if proper arrangements are not made on a past due account. • I give permission for my child to take part in school activities and absolve the school from liability for injury at school or during school related activities. • I agree to support the academic standards of the school and will not tolerate profanity or obscenity in word or action. I will not dishonor God or the Word of God, or disrespect the school. I agree to support all regulations of the school and authorize the school to discipline as it deems wise and for the training of my child. • I understand that the school reserves the right to dismiss any student who fails to comply with the established regulations or whose financial obligation remains unpaid. • If I intend to withdraw my child from the school for any reason, I will follow procedure as set forth in the student handbook.
Signature Once your online application is submitted, a member of our staff will contact you so we can get your signature on a physical copy of your application.
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