Student Enquiry Form – Shalom International School

Student First Name:

Student Last Name:

Gender:

Date of Birth

Father’s Name:

Father’s Phone Number:

Father’s Email Address:

Father’s Occupation:

Mother’s Name:

Mother’s Phone Number:

Mother’s Email Address:

Mother’s Occupation:

Residential Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Transport Facility Required:

Food Facility Required:

Current Class of Study:

Current School Name:

Current Curriculum (tick one):

Preferred Curriculum at SHALOM International School: