Student Enquiry Form

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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: *

Shalom International School

Learn Life with Character

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