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Extra Lesson Registration Form

Zinariya

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habusanisansan
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287 views1 page

Extra Lesson Registration Form

Zinariya

Uploaded by

habusanisansan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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EXTRA LESSON REGISTRATION FORM

This is to enrol as a student in Zanariya cach-up Academy Participating in Academic and social Programme. The spaces in the
academys are strictly limited and therefore place cannot be either reserved or guaranteed. All part of this form must be
properly completed.

A. PERSONAL PARTICULAR
Name:……………………………………………………………………………………………….…………………………
AFFIX
Permanent Address:……………………………………………………………………………………….……….. PASSPORT

Educational Background:………………………………D.O.B:…………………………………………………

Postal Address:…………………………………………………………………..Gender: M F

Subjects’ weakness: Mathematic English Lang Chemistry Physics Biology

B. CONTACT DETAIL
Student’s Contact No:…………………………………………………………………………………………………………………………
Father’s /Guardian’s Contact No :……………………………………………………………………………………………………...
Student’s Email Address:……………………………………………………………………………………………………………………
Residential Contact:………………………………………………………………………………………………………………….………..
Face book ID ( if any):……………………………………………………………………..………………………………………………….
C. MEDICAL DETAILS
History of medical illness:……………………………………………………………………………………………........................
Any Known congenital deformity:………………………………………………………………………………………….……………
Blood Group: …………………………………………………………………………………………………………………………………….
TERMS AND CONDITIONS
 Please attach one recent of photograph and copy of your SSCE result( if graduated)
 Fees should be paid in advance for the month. New student joining after the first week of the month,
pro-rated fee for the current month plus fees subsequent month will be charged
 Parent/Guardian ensures that the participant is physically fit and able to participate in the class.
 By signing above the parent/Legal Guardian confirm that the student has no known physical/Mental
condition preventing him participating in the above extra lesson
I have read, fully understand and agree
Where did you hear about us? to the terms and conditions
News paper/Magazine Social Media (Facebook, X) Family or Friend ……………………………………….. …………….
Signature (Parent Guardian) Date
Website/Search Engine

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