MIKINDANI ROYAL COMPREHENSIVE SCHOOL

P.O BOX 3664 – 80100 MOMBASA; TELL 0722841109, 0723163481, 0723107982

MOTTO: A Royal Beginning to a Higher Learning, A sure Foundation
www.mikindaniroyalcomprehensiveschool.com Email: helloroyalschools@gmail.com

For Official Use; To be filled by the school

ADM NO …………………………….
DATE ………………………………..
ATTACH PASSPORT CLASS ………………………………
PHOTO

RE: GRADE 1 ADMISSION FORM

A. REQUIREMENTS
i) Uniform
Uniform is compulsory and all pupils must ensure that they have the basic uniform.
Boys Girls
o Royal/Dutch blue short o True Blue blouses
o True blue shirt o Pairs white socks
o Pairs of Grey socks with white & blue stripes o Royal/Dutch blue skirts
o Pairs of black shoes o Royal/Dutch blue ties with logo
o Royal/Dutch blue ties with logo o Pairs of Black shoes
General Uniform Requirements
o House T-shirts with Mikindani Royal Comprehensive logo.
o Navy Blue truck suit with white stripes on the sides
Note: Please confirm with the school authorities for correct uniforms.
ii) During admission, Bring the following:
a. This Admission form dully filled
b. Current colored Passport Photo attached
c. Photocopies of:
i) Birth Certificate
ii) Parent/Guardian ID/or Passport
d. Stationaries:
i) 2 Squared Exercise books, 120 Pages
ii) 16 Single Line exercise books, 120 Pages
iii) 1 Drawing book, 100 pages
iv) 1 Packet of crayons
v) 1 File, 2 HB pencils, Sharpener and rubber
vi) Tissue papers 2.

Mikindani Royal Comprehensive School Page 1 of 5

PP1 Admission Form
 MIKINDANI ROYAL COMPREHENSIVE SCHOOL
P.O BOX 3664 – 80100 MOMBASA; TELL 0722841109, 0723163481, 0723107982
MOTTO: A Royal Beginning to a Higher Learning, A sure Foundation
www.mikindaniroyalcomprehensiveschool.com Email: helloroyalschools@gmail.com

B. FULL NAME OF THE PUPIL AND PARTICULARS (Please Use Block letters)

First Name ……………………………. Middle ……………………………. Surname ………………………..

Nationality …………………………… Date of Birth …………………….. Place of Birth ….…………………..

Birth Certificate No ……………………. Previous School (if transferred) …………………………………………......

First Name ……………………………. Middle ……………………………. Surname ………………………..

Nationality …………………………… ID No …………………………….. Phone No(1) ….………………….

Phone No(2) …………………………… Residence ………………………………………………………….……......

Are You Employed?

C. FULL NAME OF (Tick) YES
THE FATHER NO PARTICULARS
AND Employer …………………………………………………..
(Please Use Block letters)

Place of Work …………………………………... Employer’s address ………………………………………………….

Signature…………………………………….…... Date …………….………………………………………………….

First Name ……………………………. Middle ……………………………. Surname ………………………..

Nationality …………………………… ID No …………………………….. Phone No(1) ….………………….

Phone No(2) …………………………… Residence ………………………………………………………….……......

Are You Employed? (Tick) YES NO Employer …………………………………………………..

Place of Work …………………………………... Employer’s address ………………………………………………….

Signature…………………………………….…... Date …………….………………………………………………….

D. FULL NAME OF THE MOTHER AND PARTICULARS (Please Use Block letters)

Mikindani Royal Comprehensive School Page 2 of 5

PP1 Admission Form
 MIKINDANI ROYAL COMPREHENSIVE SCHOOL
P.O BOX 3664 – 80100 MOMBASA; TELL 0722841109, 0723163481, 0723107982
MOTTO: A Royal Beginning to a Higher Learning, A sure Foundation
www.mikindaniroyalcomprehensiveschool.com Email: helloroyalschools@gmail.com

E. FULL NAME OF THE GUARDIAN AND PARTICULARS (Please Use Block letters)

First Name ……………………………. Middle ……………………………. Surname ………………………..

Nationality …………………………… ID No …………………………….. Phone No(1) ….………………….

Phone No(2) …………………………… Residence ………………………………………………………….……......

Are You Employed? (Tick) YES NO Employer …………………………………………………..

Place of Work …………………………………... Employer’s address ………………………………………………….

Signature…………………………………….…... Date …………….………………………………………………….

LIABILITY IN CASE OF EVENTUALITY

The school authority will ensure the well being of your child during teaching sessions and outdoor activities.
We however, will not accept any liability on matters beyond our jurisdiction; in that case, we shall be held
responsible.
Parent’s Signature …………………………………
Guardian Signature ………………………………..

HEALTH RECORDS
Please notify the school authority of any complication that may be caused by or result from such or exposure to
the following
FOOD ALLERGY REACTION
Beef peanuts …………………………………….
Other related factors …………………………………….

ENVIRONMENT SENSITIVITY
Hay – fever …………………………………….
Smell …………………………………….
Asthmatic cases …………………………………….
Cold …………………………………….

Mikindani Royal Comprehensive School Page 3 of 5

PP1 Admission Form
 MIKINDANI ROYAL COMPREHENSIVE SCHOOL
P.O BOX 3664 – 80100 MOMBASA; TELL 0722841109, 0723163481, 0723107982
MOTTO: A Royal Beginning to a Higher Learning, A sure Foundation
www.mikindaniroyalcomprehensiveschool.com Email: helloroyalschools@gmail.com
MEDICINE REACTION
Aspirins …………………………………….
Antibiotics …………………………………….
Malaria pills …………………………………….

OTHER RELATED
FACTORS
Hearing (ok/partial) …………………………………….
Vision (ok/partial) …………………………………….
Speech (ok/partial) …………………………………….
Mental Perception (ok/partial)

Fits …………………………………….
Epilepsy …………………………………….

SECURITY ARRANGMENTS
The security of your child is paramount and so close to our hearts. We reserve the right to release the child,
unless one qualifies. Kindly arrange and agree as to who should bring and or collect the child to and after
school. In case the parents are not in position to do so, we need a written document, signed along with identity
card and particulars of the one designated.

DESIGNATED PERSON (TICK ONE)

1. Father
2. Mother
3. Relative
4. Friend
5. House assistance
6. Child will go home alone (by him/herself)
7. Others

Kindly in case the parent is not to collect the child, attach the particulars of the concerned party. The child
should check in and check out.
FULL NAME ………………………………………………………………………………………………….
RESIDENTIAL ADRESS ………………………………………… TEL …………………………………….
EMPLOYER …………………………………………………………………………………………………..
RELATIONSHIP WITH PARENT/GUARDIAN ……………………………………………………………

Mikindani Royal Comprehensive School Page 4 of 5

PP1 Admission Form
 MIKINDANI ROYAL COMPREHENSIVE SCHOOL
P.O BOX 3664 – 80100 MOMBASA; TELL 0722841109, 0723163481, 0723107982
MOTTO: A Royal Beginning to a Higher Learning, A sure Foundation
www.mikindaniroyalcomprehensiveschool.com Email: helloroyalschools@gmail.com
Signature ………………………………………… Date ……………………………………………………

Mikindani Royal Comprehensive School Page 5 of 5

PP1 Admission Form