The

International School of Kuala Lumpur

MIDDLE & HIGH SCHOOL

Jalan Kolam Air
68000 Ampang, Selangor
Phone (603) 4259 5600
Fax (603) 4257 9044

ELEMENTARY SCHOOL
Jalan Melawati 3
Taman Melawati
53100 Kuala Lumpur
Phone (603) 4104 3000
Fax (603) 4108 4166

Towards 50 Years of Excellence in Education

APPLICATION FOR ADMISSION

STUDENT INFORMATION

New student

E-mail [email protected]
Website www.iskl.edu.my

Returning student
Please specify the year(s) attended

Name: _______________________________________________________________________

_________________________

Preferred Name for Student Directory: _____________________________________________

Gender (M/F): _______________

Family Name

First/Given Name

Middle Name

Date of Birth: ______________________ Nationality: __________________________

MM

DD

Grade Level Applying For

Passport No: ______________________

YY

Expected Date of Enrollment: _______________ (MM / YY)

Will the student be residing with the parents?

Father:

Yes

No

Mother:

Yes

No

If No, please provide name of Guardian and relationship to student:

_________________________________________________________________________________________________________
The student must reside with the guardian. The guardian is required to work in partnership with the school (monitor the students attendance and inform the school if
the student is absent, meet with teachers and counselors when required, etc.). He/she is responsible to notify the appropriate divisional office(s) should the guardianship
arrangement be changed or terminated. If the guardianship policy is not met, the student(s) may be asked to leave school.

SIBLING INFORMATION
DATE OF BIRTH
MM/DD/YY

NAME

APPLYING TO /
ATTENDING ISKL

CURRENT
GRADE

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

LANGUAGE BACKGROUND / INFORMATION

Students Native Language: _________________________

Students Other Language(s) Spoken: _________________________

Mothers 1st Language(s): _______________________________

Fathers 1st Language(s): _______________________________

What language or languages are spoken at home?

mother to student: ________________________________

father to student: ________________________________

student to mother: ________________________________

student to father: ________________________________

mother to father: _________________________________

student to sibling/s: ______________________________

caretaker (maid, nanny, babysitter) to student: _____________________________________________________________

FOR OFFICE USE:

Application received: _______________________________________

Date to begin: __________________________________

Student ID:

Family ID:

Issue date: 8 May 2012

_______________________________________

__________________________________

Page 1 of 4

STUDENT EDUCATIONAL BACKGROUND

(Please provide comprehensive school history, beginning with the most recent school attended)

NAME OF SCHOOL

* DATES
ATTENDED

CITY/COUNTRY

From
( MM/YY )

To
( MM/YY )

TYPE OF
CURRICULUM
(AMERICAN/
BRITISH, ETC)

LANGUAGE OF
INSTRUCTION

* The students present school has an academic year that runs from: _____________________

GRADE/
STANDARD/
FORM/ YR

to: ______________________

(Month)

(Month)

Please indicate the type of grading period your childs current school uses:
Semester (2 terms)

Trimester (3 terms)

Quarter (4 terms)

Other _____________________________________________________________________________________________

ADDITIONAL INFORMATION
1.

Has the student had any assessments/evaluations (e.g., psycho-educational, psychological, etc.)?

Yes

No

If Yes, please provide details ______________________________________________________________________________

(Please attach relevant reports and test results)

2.

Has the student been recommended for or received any academic, social or emotional support
(e.g., speech, learning resource, counseling, etc)?

Yes

No

If yes, what type of support has the student received? _________________________________________________________

(Please attach relevant reports and test results)

3.

Has the student ever been in an English as an Additional Language (EAL) program?

Yes

No

If Yes, please specify year(s) _____________________________________________________________________________

4.

Has the student ever been in a gifted and talented or honors program?

Yes

No

If Yes, please provide details ______________________________________________________________________________

5.

Has the student ever repeated a grade level?

Yes

No

If Yes, please provide details ______________________________________________________________________________

6.

Has the student ever skipped a grade (double promotion)?

Yes

No

If Yes, please provide details ______________________________________________________________________________

7.

Has the student ever been asked to leave a school?

Yes

No

If Yes, please provide details ______________________________________________________________________________

8.

Does the student have any health concerns, medical conditions, and/or take any medications?

Yes

No

If Yes, please provide details ______________________________________________________________________________

9.

Does the student find adjusting to new situations difficult?

Yes

No

If Yes, please provide details ______________________________________________________________________________

10. Other comments to assist the teacher: _______________________________________________________________________
__________________________________________________________________________________________________________

FOR MIDDLE AND HIGH SCHOOL STUDENTS:

Please list extra-curricular activities: _____________________________________________________________________________
__________________________________________________________________________________________________________

Issue date: 8 May 2012

Page 2 of 4

PARENT / GUARDIAN INFORMATION

Preferred mailing address for school correspondence

(Please complete page 3 only once per family)

Home

Office: _______________________________
(If so, which parent?)

1 . Information of:
Dr.

Mr.

Father
Mrs.

Step-Father

Guardian

Ms. Name: _____________________________________________ Date of Birth: ______________

Family Name

First Name

Middle Name

Nationality: _________________ Are you an ISKL alumnus? ______ If so, which year(s)? _________ Class of: _____________
(Even if graduated elsewhere)

Home address (Local): ____________________________________________________________________________________

(If not available, you may leave this section blank. Please update us with your new address as soon as you have established your local residence.)

_____________________________________________ Postcode: ______________ Home Phone: _____________________

Company Name (Local): ___________________________________________________________________________________
Parent Company: ________________________________________________________________________________________
Office Address (Local): ____________________________________________________________________________________
_____________________________________________________________________________ Postcode: ________________
Office Phone: __________________________ Direct Line: ________________________ Office Fax: _____________________
Type of Industry: ____________________________ Designation/Job Title: _________________________________________
Mobile Phone: __________________________ Email: _________________________________________________________
Is the company a U.S. affiliate?
If Yes, please provide type:

Yes

No

US Government

US Dept. of Defense

Private Company

Contracted to US Gov agency

U.S. Company Name and Address: ___________________________________________________________________________

_______________________________________________________________________________________________________
2 . Information of:
Dr.

Mr.

Mother
Mrs.

Step-Mother

Guardian

Ms. Name: _____________________________________________ Date of Birth: ______________

Family Name

First Name

Middle Name

Nationality: _________________ Are you an ISKL alumnus? ______ If so, which year(s)? _________ Class of: _____________
(Even if graduated elsewhere)

Home address (Local): ____________________________________________________________________________________

(If not available, you may leave this section blank. Please update us with your new address as soon as you have established your local residence)

_____________________________________________ Postcode: ______________ Home Phone: _____________________

Company Name (Local): ___________________________________________________________________________________
Parent Company: ________________________________________________________________________________________
Office Address (Local): ____________________________________________________________________________________
_____________________________________________________________________________ Postcode: ________________
Office Phone: __________________________ Direct Line: ________________________ Office Fax: _____________________
Type of Industry: ____________________________ Designation/Job Title: _________________________________________
Mobile Phone: __________________________ Email: _________________________________________________________
Is the company a U.S. affiliate?
If Yes, please provide type:

Yes

No

US Government

US Dept. of Defense

Private Company

Contracted to US Gov agency

U.S. Company Name and Address: ___________________________________________________________________________

_______________________________________________________________________________________________________

BILLING INFORMATION
Does either company above pay tuition fees:

Yes

If Yes, what percentage of fees does the company pay?

Billing address:

Home

No

Which parent? _______________________

_______________
Office

If billing should be sent to another person/address, please provide information below:

Name: ___________________________________________________________________________________________________
Address: _________________________________________________________________________________________________
_________________________________________________________________________________________________________
Issue date: 8 May 2012

Page 3 of 4

AGREEMENT BETWEEN THE INTERNATIONAL SCHOOL OF KUALA LUMPUR (ISKL)

AND PARENTS/GUARDIANS
It is vitally important to us at ISKL to facilitate safe, secure and caring environments on both of our campuses and during all school
activities. Our campuses and off campus events provide pleasant and stimulating venues where each student has the optimal opportunity
to learn and reach his/her respective potential. The following expectations/agreements are presented with the above in mind. Having
clear, concise guidelines is consistent with our mission and vision, limits surprises and enhances learning. Your cooperation and
encouragement will assist us to provide an exceptional education to your students.
I/We desire to enroll _______________________________________________________________________ as a student at the
Family Name

First/Given Name

Middle Name

International School of Kuala Lumpur. If this applicant is successful,

I/We hereby agree to the following conditions of enrollment:
I/We agree to accept and support the Mission and Vision of ISKL and be bound by the rules governing ISKL, the authority of the Head of
School and the Board of Directors.
I/We agree that ISKL reserves the right, following admission, to discontinue the enrollment of a student at any time if it becomes evident
that ISKL was misinformed regarding any application documentation or it becomes evident that ISKL does not have the resources to
address successfully the individual needs of that student.
I/We agree that it is my/our obligation to ensure that the fees due are paid on time, regardless of whether a letter from a company or
organization is provided clearly accepting its full liability for fee payments.
I/ We agree to pay all fees as detailed on fee invoices and I/We understand that failure to pay on or before the requested date has
consequences, which include the possible exclusion of my child from attending ISKL.
I/We agree to accept and be bound by the rules governing health and medical requirements for the safety of all students and faculty at
ISKL. It is our obligation to ensure that evidence of required medical examinations, along with evidence of required immunizations are
provided to ISKL within the stipulated period. I/We understand and accept that students may be required to undergo further medical
emergency and/or safety precautionary measures during times of disease outbreak, or where medical investigative measures are
deemed necessary by school policy or the Head of School.
I/We agree that ISKL will initiate emergency measures in the event of an accident or illness with the understanding that I will be notified
as soon as possible.
I/We agree that my Middle School/High School child will participate in ISKLs mandatory drug testing program.
I/We agree that ISKL has a position in loco parentis and as such the teacher can exercise on behalf of parents, such discipline they
regard as necessary or expedient for the student in accordance with the guidelines set down in ISKLs divisional handbooks.
I/We agree that ISKL may at its discretion, suspend or terminate a students enrollment for failure to comply with the conditions of this
Agreement, as well as for other serious breaches of ISKLs rules and regulations.
I/We agree to allow my child, to involve themselves in ISKLs activities, including excursions/ field trips arranged by ISKL.
I/We agree that my child will participate in all external assessments ISKL utilizes to make individual and school-wide instructional and
program decisions.
I/We agree to subscribe to the communication systems utilized by ISKL for emergency and routine communication and abide by ISKLs
acceptable use policies for technology use.
I/We agree to have our contact details published in the ISKL directory unless otherwise notified by us in writing to ISKL.
I/We agree that student photographs, images and recordings can be used for school marketing materials.
I/We agree to indemnify and hold harmless ISKL and its directors, management, and staff in respect of any liability arising from school
activities and further recognize my/our responsibility to obtain personal accident insurance coverage for our said child in addition to that
provided by ISKL, which covers medical expenses up to RM10,000.

Signature: _______________________________________

Date: _____________________________

Parent / Guardian

Issue date: 8 May 2012

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