Primary Application Form

Form Filler's Details

Full Name (required)

Relationship to the Applicant

Your Email (required)

Child's Info

Upload Child's Passport (required)

Child's Name [surname first] (required)

Child's Pet Name

Child's Date of Birth (required)

Religion (required)
—Please choose an option—ChristianityIslamOther

Gender (required)
—Please choose an option—MaleFemale

Number of Siblings

Position in the Family

Home Address (required)

Last School Attended (if any)

Class

Reason for Leaving

Please attach last term's report sheet

Background Information

Father's Name (required)

Occupation (required)

Residential Address (required)

Office Address (required)

Phone Number (required)

Additional Phone Number

Email Address

Mother's Name (required)

Occupation (required)

Residential Address (required)

Office Address (required)

Phone Number (required)

Additional Phone Number

Email Address

Parents Living Together (required)
YesNo

Separated (required)
YesNo

Divorced (required)
YesNo

Single Parent
YesNo

Special Circumstance

Custodial Information

Who has legal custody of the child?

Who collects the child after school daily?

(Please inform the school if this changes)

Hospital Details

Name and Address of Family Doctor/Hospital

Doctor's Phone Number

Your Hospital Card Number

Immunization History

Please attach copy of immunization card

Health Status

Please state truthfully, your child's fitness for school

Allergies (if any)(separate by commas)

Other Health Conditions we need to know of, including those regarding e.g., Sight, Hearing, Feeling, etc

Please give names and phone numbers of 2 people to call in case we can’t reach you in an emergency
Name 1 (required)

Phone Number (required)

Name 2 (required)

Phone Number (required)

I declare that the information supplied by me is a true and accurate description of my child and his/her family situation. I agree that if in the future, while my child is in the care of Rubygates Preparatory School, any of this is found to be inaccurate, I may be asked to withdraw my child, and all fees paid forfeited. I declare that I am committed to making appropriate arrangement to collect my ward on time daily and within the daily grace period and agree that if I collect my ward later than the daily grace period, I should be billed for late collection based on my signed in collection time and to pay Late Collection Fees as and when due.