Pupil Name *

First

Middle

Last

Sex *

• Male
• Female

Home Address *

Father's Full Names *

Father's Profession *

Father's Office Address *

Father's Contact Telephone *

Mother's Full Names *

Mother's Profession *

Mother's Office Address *

Mother's Contact Telephone *

Pupil's State of Origin *

Pupil's Previous School *

Pupil's Previous Class *

Pupil's Present Class *

Religion *

• Christianity
• Islam

Any known allergy or special needs *

Email Address *

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