Child Registration Form

QINS ADMISSION FORM

    Child's Full Name

    Child's Date of Birth

    Child's Place of Birth

    1st Parent's/Guardian's Name

    1st Parent/Guardian Phone Number

    Email

    Postal Address

    Place of work

    2nd Parent/Guardian Name

    2nd Parent/Guardian Phone Number

    Email

    Postal Address

    Place of work

    Child Residence Details
    LC

    Parish

    Zone

    Emergency Phone Number

    With whom does Child live?

    Name of Family Doctor

    Doctor Phone number

    Is Child a special needs?

    If Yes, give details of health complications

    Attach birth Certificate

    Attach Passport-sized Photo

    Attach Child Immunization card