WEE KIDZ FUTURE SCHOLARS PRE-SCHOOL APPLICATION FORM
Wee Kidz Future Scholars Pre-School
#4 Mango Blossom Road
St. James, Port-of-Spain
Trinidad Picture of Child
Telephone:622-1345
E-mail: [email protected]
Weebly: http://weekidzfuturescholars.weebly.com
Date Application was completed: ………………………………………………………….
Name of Child:………………… ……………………. ………………………
First Middle Surname
Date of Birth: …………………. …………………… ………………………
Day Month Year
Gender: Female Male
Child’s Address: ……………………………………………………………………………
Religion: ……………………………………………………………………………………
Place of Birth: ……………………………… Nationality: ………………………...
Date of Admission to Pre-School: …………………………………………………………
Mother’s Name: ……………………………………………………………………………
Mother’s Place of Employment: …………………………………………………………..
Mother’s Job Description: ………………………………………………………………….
Length of time employed with company: …………………………………………………
Telephone Numbers: (C)………………………………….
(W)…………………………………
(H)………………………………….
E-mail Address: ………………………………………………………………………….
Father’s Name: ……………………………………………………………………………
Father’s Place of Employment: …………………………………………………………….
Telephone Numbers: (C)………………………………….
(W)…………………………………
(H)………………………………….
E-mail Address: ……………………………………………………………………………
Father’s Job Description: ………………………………………………………………...
Length of time employed with company: ………………………………………………….
EMERGENCY CONTACT INFORMATION (other than parents) AND PERSONS AUTHORIZED TO PICK CHILD UP.
Emergency Contact Name: ………………………………………………………………..
Emergency Contact Number: ………………………………………………………………
ID/DP/Passport #: ………………………………………………………………………….
Relationship to Child: ………………………………
Emergency Contact Name: ………………………………………………………………..
Emergency Contact Number: ………………………………………………………………
ID/DP/Passport #: ………………………………………………………………………….
Relationship to Child: ………………………………
Emergency Contact Names: ………………………………………………………………..
Emergency Contact Numbers: ……………………………………………………………..
ID/DP/Passport #: …………………………………………………………………………
Relationship to Child: …………………………….
It is of utmost importance all contact information is kept up to date.
Doctor’s Name: ……………………………. Telephone Number: ………………
Does your child suffer from any Allergies? Yes No
If yes please give details: …………………………………………………………………..
………………………………………………………………………………………………
Does your child have any Medical Problems? Yes No
If yes please give details: …………..………………………………………………………
Were there any problems during pregnancy? Yes No
If yes please give details: …………………………………………………………………..
………………………………………………………………………………………………
Please find attached:
Photocopy of Birth Certificate
Photocopy of Immunization Card
NOTE ORIGINAL IMMUNIZATION CARD IS TO BE SHOWN UPON REGISTRATION.
APPLICATION FORM MUST BE COMPLETELY FILLED OUT BEFORE IT CAN BE PROCESSED
CHILDREN ARE ACCEPTED ON A FIRST COME FIRST SERVE BASIS BASED ON THE DATE OF THE COMPLETED APPLICATION FORM
THE MANAGEMENT WEE KIDZ FUTURE SCHOLARS PRE-SCHOOL HAS THE RIGHT TO REFUSE ADMISSION TO THE PRE-SCHOOL
……………………………………………. ………………………
Signature of Parent Date
Wee Kidz Future Scholars Pre-School
#4 Mango Blossom Road
St. James, Port-of-Spain
Trinidad Picture of Child
Telephone:622-1345
E-mail: [email protected]
Weebly: http://weekidzfuturescholars.weebly.com
Date Application was completed: ………………………………………………………….
Name of Child:………………… ……………………. ………………………
First Middle Surname
Date of Birth: …………………. …………………… ………………………
Day Month Year
Gender: Female Male
Child’s Address: ……………………………………………………………………………
Religion: ……………………………………………………………………………………
Place of Birth: ……………………………… Nationality: ………………………...
Date of Admission to Pre-School: …………………………………………………………
Mother’s Name: ……………………………………………………………………………
Mother’s Place of Employment: …………………………………………………………..
Mother’s Job Description: ………………………………………………………………….
Length of time employed with company: …………………………………………………
Telephone Numbers: (C)………………………………….
(W)…………………………………
(H)………………………………….
E-mail Address: ………………………………………………………………………….
Father’s Name: ……………………………………………………………………………
Father’s Place of Employment: …………………………………………………………….
Telephone Numbers: (C)………………………………….
(W)…………………………………
(H)………………………………….
E-mail Address: ……………………………………………………………………………
Father’s Job Description: ………………………………………………………………...
Length of time employed with company: ………………………………………………….
EMERGENCY CONTACT INFORMATION (other than parents) AND PERSONS AUTHORIZED TO PICK CHILD UP.
Emergency Contact Name: ………………………………………………………………..
Emergency Contact Number: ………………………………………………………………
ID/DP/Passport #: ………………………………………………………………………….
Relationship to Child: ………………………………
Emergency Contact Name: ………………………………………………………………..
Emergency Contact Number: ………………………………………………………………
ID/DP/Passport #: ………………………………………………………………………….
Relationship to Child: ………………………………
Emergency Contact Names: ………………………………………………………………..
Emergency Contact Numbers: ……………………………………………………………..
ID/DP/Passport #: …………………………………………………………………………
Relationship to Child: …………………………….
It is of utmost importance all contact information is kept up to date.
Doctor’s Name: ……………………………. Telephone Number: ………………
Does your child suffer from any Allergies? Yes No
If yes please give details: …………………………………………………………………..
………………………………………………………………………………………………
Does your child have any Medical Problems? Yes No
If yes please give details: …………..………………………………………………………
Were there any problems during pregnancy? Yes No
If yes please give details: …………………………………………………………………..
………………………………………………………………………………………………
Please find attached:
Photocopy of Birth Certificate
Photocopy of Immunization Card
NOTE ORIGINAL IMMUNIZATION CARD IS TO BE SHOWN UPON REGISTRATION.
APPLICATION FORM MUST BE COMPLETELY FILLED OUT BEFORE IT CAN BE PROCESSED
CHILDREN ARE ACCEPTED ON A FIRST COME FIRST SERVE BASIS BASED ON THE DATE OF THE COMPLETED APPLICATION FORM
THE MANAGEMENT WEE KIDZ FUTURE SCHOLARS PRE-SCHOOL HAS THE RIGHT TO REFUSE ADMISSION TO THE PRE-SCHOOL
……………………………………………. ………………………
Signature of Parent Date