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Enrollment Form

Brightminds School

New Student Admission Form
Thank you for your interest in Brightminds School.
Kindly complete this form carefully and ensure that all information provided is accurate.
This document forms part of the admission review process.

1

Student Info

2

Parent/Guardian

3

Emergency & Medical

4

Academic Background

5

Submit

Student Information

Full Name of Child *

Date of Birth *

Gender *

Nationality *

State of Origin *

Residential Address *

Previous School Attended (if applicable)

Class Applying For *

Proposed Start Date *

Parent/Guardian Information

Father's Information

Father's Full Name *

Occupation *

Phone Number *

Email Address *

Mother's Information

Mother's Full Name *

Occupation *

Phone Number *

Email Address *

Primary Contact Person (if different from parents)

Relationship to Child

Phone Number

Emergency & Medical Information

Emergency Contact

Name of Emergency Contact *

Relationship to Child *

Phone Number *

Alternative Phone Number

Medical & Special Information

Does the child have any medical condition?

No Yes

Please specify the medical condition:

Does the child have any allergies?

Is the child currently on any medication?

No Yes

Please specify the medication:

Does the child require any special learning support?

No Yes

Please specify the type of support needed:

Academic & Development Background

Child's Strengths and Interests

Areas Where Additional Support May Be Required

Has the child ever repeated a class?

No Yes

Has the child ever been suspended or withdrawn from a school?

No Yes

Please explain:

Additional Information

How did you hear about Brightminds School?

Why would you like your child to attend Brightminds School?

Review & Submit Application

Application Summary

Declaration: I hereby declare that the information provided in this application form is true and accurate to the best of my knowledge. I understand that providing false or misleading information may affect the admission process.

Application Submitted Successfully!

Thank you for applying to Brightminds School. Your application has been received and is being processed.

Reference Number: -

We will review your application and contact you within 5-7 business days.
Please keep this reference number for your records.

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