VIENNA COLLEGE, NAMUGONGO

P.O. Box 27588 Kampala, Uganda. Tel: 256 772 221 557, 256 393 261 911
Email: info@vienna.ug www.vienna.ug

‘A’ LEVEL CIE ADMISSION FORM

MALE FEMALE
CHILD’S PARTICULARS

Name_____________________________________________________________________
2 PASSPORT
Surname First Name Middle Name
PHOTOGRAPHS

Date of Birth ____________________ Place of Birth ______________________________

Day / Month / Year

Nationality____________________________ Religion___________________________

PREVIOUS SCHOOL(S) ATTENDED

Name of School From (Month / Year) To (Month / Year) Grade / Level

‘O’ LEVEL / IGCSE RESULTS

1. ENGLISH ………………. 9. ECONOMICS ………………

2. MATHEMATICS ………………. 10. SOCIOLOGY ………………

3. BIOLOGY ………………. 11. ENGLISH LITERATURE ………………….

4. CHEMISTRY ………………. 12. FRENCH …………………..

5. PHYSICS ………………. 13. BUSINESS STUDIES ……………………

6. GEOGRAPHY ………………. 14. AICT …………………….

7. ART & DESIGN ……………….

8. HISTORY ……………….

1
 CIE AS / ‘A’ LEVEL BLOCKS

A B C D E F G
Biology History Chemistry Literature Business Studies Mathematics Art & Design
Economics Physics Sociology French Geography Applied IT
English

1st Choice Subjects _______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

2nd Choice Subjects _______________________________________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

Signatures,

___________________________ ___________________________
Parent Student

• Provisional admission is subject to the students passing ‘O’ Levels / IGCSE at a satisfactory grade level with a
minimum of five (5) credits.

2
FATHER: Name___________________________________________________Nationality ________________________
Surname First Name Middle Name
Company Name_____________________________________________Position________________________________

Office Address_____________________________________________________________________________________

Tel No________________________________________E mail Address_______________________________________

Home Address_____________________________________________________________________________________

__________________________________________________ Tel. No. ________________________________________

MOTHER: Name_________________________________________________ Nationality _________________________

Surname First Name Middle Name
Company Name_____________________________________________ Position________________________________

Office Address_____________________________________________________________________________________

Tel. No.________________________________________E mail Address______________________________________

Home Address_____________________________________________________________________________________

__________________________________________________ Tel. No. ________________________________________

GUARDIAN: (If the child is not staying with parents and essential for non-Ugandan students).

Relationship_________________________________________
Name__________________________________________________ Nationality _________________________________
Surname First Name Middle Name

Company Name_____________________________________________ Position________________________________

Office Address_____________________________________________________________________________________

Tel No________________________________________E mail Address_______________________________________

Home Address_____________________________________________________________________________________

_________________________________________ Tel. No. _________________________________________________

Address for Correspondence:

Office Address of Father Home Address of Father

Mother Mother

Guardian Guardian

3
I, …………………………………………………… parent of…………………………………………………………….

have read, understood and support the College Code of Behaviour and appreciate that should my son /

daughter commit a major breach of school discipline, the College reserves the right to exclude the student from

the school with no redress of fees paid.

Parent’s Name ………………………………………………………………………………………………………

Parent’s Signature ……………………………………………………… Date……………………………………

Student’s Name ……………………………………………………………………………………………………

Student’s E-mail ……………………………………………………………………………….

Student’s Signature ………………………………………………… Date……………………………………….

Guardian‘s Name. (If appropriate)………………………………………………………………………………

Guardian’s Signature …………………………………………………… Date…………………………………