STUDENT INFORMATION Student name * First Middle Last Gender * — Select — Male Female Joining Date * Entry Grade * — Select — Kindergarten (ages 1 to 6) Montessori Pre-School (Ages 1-4) Nursery (Ages 4-5) Reception (Ages 5-6) Primary School (Grade 1 – 6: Ages 6 to 12) Date of birth * Nationality * Religion * PARENT/GUARDIAN/FAMILY INFORMATION PARENT/GUARDIAN 1 Parent/Gurdian 1 * First Middle Last Postal address * Residential address * Mobile * Work Telephone * Home Telephone * Email Address * Occupation * Name and address of employer * PARENT/GUARDIAN 2 Parent/Gurdian 2 name * First Middle Last Postal address 2 * Residential address 2 * Mobile 2 * Work Telephone 2 * Home Telephone 2 * Email Address 2 * Occupation 2 * Name & address of employer 2 * EMERGENCY CONTACT 1 INFORMATION Name 1 * First Middle Last Relationship with child 1 * Mobile No. 1 * Office Telephone No. 1 * Email 1 * EMERGENCY CONTACT 2 INFORMATION Name 2 * First Middle Last Mobile No. 2 Office Telephone No. 2 Email 2 Relationship with child 2 * Does child have any general health challenges such as physical handicaps, pre-existing illnesses, special needs medical conditions any long-term continuous use of medication or the constant care of a physician, psychiatrist or psychologist which would limit their participation in the full range of School activities? Examples of special needs include delayed speech, hearing difficulties. limited hearing or any special needs or learning difficulties - examples of special needs include autism, asthma, epilepsy, Down syndrome, autism, dyslexia, processing disorders, ADD, blind, visually impaired, deaf etc. * — Select — YES NO If yes, list any health and development challenges. ATTACHMENTS Child's birth certificate * Select Image Upload only images; we don't accept PDF or Word files. Child's Vaccination form * Select Image Only attach jpeg or png images - we do not accept PDF or Word files Child's passport size photo * Select Image Only attach jpeg or png images - we do not accept PDF or Word files Parent/Guardian 1 ID/Passport copies * Select Image Only attach jpeg or png images - we do not accept PDF or Word files Parent/Guardian 2 ID/Passport copies * Select Image Only attach jpeg or png images - we do not accept PDF or Word files You consent to the school using the personal data provided on this application in line with the school’s ‘Data Protection Policy‘ which is available on this link, and may be amended from time to time and where otherwise reasonably necessary for the school to provide appropriate services. You acknowledge that you can withdraw your consent at any time by contacting us at info@beescircleschool.com. I have read and agree to the Privacy Policy * I Agree 0734 860 317 | 0727 821 128 Kiambu Rd, Nairobi info@beescircleschool.com
