Student Registration


Date Today

STUDENT INFORMATION

Name

Date Of Birth

MyKid No.

Home Address

 

Father's Name

Primary Contact

Occupation

Other Contact No

Email

 

Mother's Name

Primary Contact

Occupation

Other Contact No

Email

Emergency Contact No

Other Information (Known Allergies, Disabilities, etc.)


ALIMKIDS PROGRAM SUBSCRIPTION

Please Tick

 Playgroup Playschool (4 Years Old) Preschool (5 Years Old) Preschool (6 Years Old) Unwind@ALIMkids Lunch

Additional Note :


FOR OFFICE USE

Ref Number :

Date Received :

Registered With :