APPLICATION FORM

INTERNAL USE ONLY

DATE OF RECEPTION dd / mm / yyyy REGISTRATION NO.
DATE OF BIRTH dd / mm / yyyy PRE-REGISTRATION FOR THE ROOM GRADE OR CLASS

GENERAL INFORMATION
STUDENT
FULL NAME ▪

CARD/ID/PASSPORT EXPIRE DATE

RESIDENCE ADDRESS
PLACE OF BIRTH NATIONALITY
VISA TYPE

ISSUANCE DATE dd / mm / yyyy END DATE dd / mm / yyyy

FATHER PARENT/GUARDIAN YES NO

FULL NAME
RESIDENCE ADDRESS
PLACE OF BIRTH ▪ NATIONALITY ▪

PHONE NUMBER ▪ MOBILE NUMBER ▪

EMAIL
QUALIFICATIONS ▪

OCCUPATION WORK ADDRESSS

VISA TYPE
ISSUANCE DATE dd / mm / yyyy END DATE dd / mm / yyyy

MOTHER PARENT/GUARDIAN YES NO

FULL NAME
RESIDENCE ADDRESS
PLACE OF BIRTH ▪ NATIONALITY ▪

PHONE NUMBER ▪ MOBILE NUMBER ▪

EMAIL
QUALIFICATIONS
OCCUPATION WORK ADDRESSS
VISA TYPE
ISSUANCE DATE dd / mm / yyyy END DATE

09|2017
STUDENT GENERAL INFORMATION
# PEOPLE OF THE
AGES
FAMILY AGGREGATE?
BROTHERS
YES NO AGES / YEARS / CLASSES
FREQUENTING SCHOOL?
DOES THE STUDENT PRESENT NEED EDUCATIONAL / SPECIAL CARE? YES NO

IF YES, PLEASE SPECIFY

IDIOMS
1ST LANGUAGE 2ST LANGUAGE

LANGUAGE SPOKEN WITH THE PARENTS IS A BILINGUAL STUDENT? YES NO

ACADEMIC HISTORY (please, provide accurate data in order to be correctly read the equivalent year)
AGE SCHOOL YEAR ACADEMIC YEAR NAME OF SCHOOL/HIGH SCHOOL

INTERVIEW DATE dd / mm / yyyy INTERVIEWER

REMARKS ▪

FEEDBACK

ADMISSION YES NO DATE dd / mm / yyyy

FEE PAYMENT INFORMATION (for invoicing)

FEES WILL BE PAID BY FATHER ☐ MOTHER ☐

NOTE: I have become aware of the existence of the Rules of Procedure, Philosophy and Teaching Rules of Grand International School, as
well as the forms and deadlines for payment.

HAS THE STUDENT BEEN SUBJECT TO DISCIPLINARY ACTION AT ANY TIME? YES NO
IF YES, PLEASE SPECIFY ▪

SIGNATURE OF THE PARENT/GUARDIAN

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