Kingsley Admission Form-15 Sept 17
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KINGSLEY INTERNATIONAL SCHOOL Tel : +603 5481 6090 Managed by Kingsley International Sdn. Bhd. (924077-A) Fax : +603 5481 6091 Kingsley International School, Email : [email protected] Persiaran Kingsley, Kingsley Hills, Web : www.kingsley.edu.my 47650 Putra Heights, Subang Jaya, Selangor, MALAYSIA. KINGSLEY INTERNATIONAL SCHOOL APPLICATION FOR ADMISSION Level Applied For : Term Applied For : Student Code : Student’s Father/Mother/ Photo Admission Date : Level : Guardian’s Photo Leaving Date : Class : (Office use only) A: CHILD’S PERSONAL DATA (A separate form should be completed for each child. Please use BLOCK LETTERS throughout) Name as in Birth Certificate : (Underline your surname) Gender : Male Female Preferred Name : IC No (Malaysia only) : Nationality : Passport No : Religion : Type of Visa : Race : Language (Spoken at home) : Birth Cert.No : Other Languages : Country of Birth : Date of Birth (DD/MM/YY) : Home Address : Correspondence Address : (If different from above) B: PREVIOUS SCHOOL (Begin with the most recent) Joining Leaving No Name of School Country Level Was this an Date Date international school? 1. Yes No 2. Yes No 3. Yes No 4. Yes No 5. Yes No Please list the co-curricular activities that the student has participated in at school level: No Clubs / Societies Sports Competitions Participated in 1. 2. 3. 4. Doc No: KISB-FM-002(2) Rev. Date: 15 September 17 1 KINGSLEY INTERNATIONAL SCHOOL Tel : +603 5481 6090 Managed by Kingsley International Sdn. Bhd. (924077-A) Fax : +603 5481 6091 Kingsley International School, Email : [email protected] Persiaran Kingsley, Kingsley Hills, Web : www.kingsley.edu.my 47650 Putra Heights, Subang Jaya, Selangor, MALAYSIA. KINGSLEY INTERNATIONAL SCHOOL APPLICATION FOR ADMISSION C: INFORMATION OF SIBLINGS No Name Date of Birth Gender School Level 1. 2. 3. 4. D: DETAILS OF PARENTS/ GUARDIAN FATHER MOTHER Title (Mr/Ms/Mds/Dr/Dato’) : Title (Mr/Ms/Mds/Dr/Dato’) : Name (As in passport, Name (As in passport, please underline surname) : please underline surname) : Nationality : Nationality : IC No (Malaysian only) : IC No (Malaysian only) : Passport No : Passport No : Type of Visa : Type of Visa : Job Designation : Job Designation : Company : Company : Company Address : Company Address : Telephone (O) : Telephone (O) : Home Address : Home Address : Telephone (H) : Telephone (H) : Mobile : Mobile : Email : Email : Parents’ Marital Status: Married Divorced Separated Widowed Others DETAILS OF GUARDIAN (Must be completed if child is not staying with parents) Title (Mr/Ms/Mds/Dr/Dato’) : Relationship to the child : Name (As in passport, please underline surname) : Passport No : Nationality : Type of Visa : Company Name : Telephone (H) : Job Designation : Telephone (O) : Email : Mobile : Company Address : Home Address : Doc No: KISB-FM-002(2) Rev. Date: 15 September 17 2 KINGSLEY INTERNATIONAL SCHOOL Tel : +603 5481 6090 Managed by Kingsley International Sdn. Bhd. (924077-A) Fax : +603 5481 6091 Kingsley International School, Email : [email protected] Persiaran Kingsley, Kingsley Hills, Web : www.kingsley.edu.my 47650 Putra Heights, Subang Jaya, Selangor, MALAYSIA. KINGSLEY INTERNATIONAL SCHOOL APPLICATION FOR ADMISSION EMERGENCY CONTACT (If parents are not reachable in case of an emergency) Name (Please underline surname) : Telephone (O) : Relationship to the child : Telephone (H) : Email : Mobile : E: STUDENT’S HEALTH HISTORY & SPECIAL NEEDS I NFORMATION: Diet : Vegetarian Non-Vegetarian 1. Does the student suffer from any major illness ? YES NO Yes,please give details 2. Does the student have any allergies? YES NO Yes,please give details 3. Is the s tudent taking any medication on a regular basis? YES NO Yes,please give details 4. Does the student have any physical health limitations? YES NO Yes,please give details 5. Does the student have any special skills or interests (sports, music, drama, dan ce, etc)? YES NO Yes,please give details 6. Has the student ever been in a gifted or tale n ted p rogramm e ? YES NO Yes,please give details 7. Does the st udent have any physical disabilities, leaning difficulties or psychological needs? YES NO Yes,please give details 8. Has the student been involved in serious disciplinary action? YES NO Yes,please give details 9. Has the student been in an English as Second Language Programme? YES NO Yes,please give details 10. Friendship patterns: Makes friends easily and quickly Is initially shy with people Prefers a small group of close friends Has difficulty in making friends 11. Any information the parents/guardian would like the School to take note of regarding the student? F: GENERAL INFORMATION 1. How did you hear about us? Friends Website Embassy in Malaysia At work Seminar Press Agent Exhibition Chamber of commerce Email marketing Others : 2. What are the most important factors for you when choosing a school? Curriculum Student diversity Location Extra-curriculum Facilities & Resources Summer ca m p Academic Standards Class Size Quality of Teachers Others : Doc No: KISB-FM-002(2) Rev. Date: 15 September 17 3 KINGSLEY INTERNATIONAL SCHOOL Tel : +603 5481 6090 Managed by Kingsley International Sdn. Bhd. (924077-A) Fax : +603 5481 6091 Kingsley International School, Email : [email protected] Persiaran Kingsley, Kingsley Hills, Web : www.kingsley.edu.my 47650 Putra Heights, Subang Jaya, Selangor, MALAYSIA. KINGSLEY INTERNATIONAL SCHOOL APPLICATION FOR ADMISSION G: PAYMENT DETAILS Payable To Kingsley International Sdn Bhd Company No 924077-A Tel No. +603 5481 6090 Fax No. +603 5481 6091 Email [email protected] Bank CIMB BANK BHD Bank Address 31-1, Jalan USJ 9/5S, UEP Subang Jaya, 47620 Petaling Jaya, Selangor Account No 8002022996 Country Malaysia Swift Code CIBBMYKL H: BILLING DETAILS School Fees paid by : Employer [ %] Parents [ %] Guardian [ %] Bill To : BILLING DETAILS (To be completed if payment is not made by parents or guardians) INDIVIDUALS Name (Please underline surname) : Telephone (O) : Relationship to child : Telephone (H) : Email : Mobile : Address : COMPANY Company’s Name : Person In Charge’s Name : Telephone (O) : Designation : Fax (O) : Email : Address : I: AGENT DETAILS If an applicant/student is being introduced by an approved agent, please complete the following: Name of Agency : Contact Name : Telephone (O) : Email : Telephone (H) : Mobile : Fax (O) : Office Address : Doc No: KISB-FM-002(2) Rev. Date: 15 September 17 4 KINGSLEY INTERNATIONAL SCHOOL Tel : +603 5481 6090 Managed by Kingsley International Sdn. Bhd. (924077-A) Fax : +603 5481 6091 Kingsley International School, Email : [email protected] Persiaran Kingsley, Kingsley Hills, Web : www.kingsley.edu.my 47650 Putra Heights, Subang Jaya, Selangor, MALAYSIA. KINGSLEY INTERNATIONAL SCHOOL APPLICATION FOR ADMISSION J: REFUND OF DEPOSIT (For the purpose of cheque payment if all conditions pertaining to the refund are adhered to) Refund of deposit shall be made payable to : (Crossed cheque for qualified refund of deposit will be made to the person as stated above.) K: CONDITIONS GOVERNING ENROLMENT AND ADMISSIONS All parents are advised to read the policies, terms and conditions governing the admission at Kingsley International School (the School) and the child’s continued enrolment as student, as set out below. 1. The Application for Admission Form must be duly and accurately completed and accompanied with a crossed cheque or bank draft made payable to KINGSLEY INTERNATIONAL SDN BHD for an Application & Registration fee at the current rate for the application. 2. The Application Fee is non-transferable and non-refundable regardless whether the child is successfully admitted to the School or otherwise. The receipt of the Application Fee does not oblige the School to admit the child. 3. The application & registration fee is valid for 12 months from the receipt date. 4. To provide a copy of the child’s most recent school academic and behaviour report at the time of application. 5. On being offered a place, the Parents shall immediately pay the required school fees (including the refundable deposit) at the rate applicable for the term for which the place is offered. Please note that the fees are normally reviewed on an annual basis and the fees indicated on the current fee structure may not be the fees applicable for the term for which the place is offered. 6. All fees are to be paid before the commencement of each term (3 terms per year). Students are not allowed to attend class unless all fees payable are paid. The School reserves the right to impose a late payment charge of 5% per annum on all outstanding fees which have not been paid by the 7th day from the due date. 7. Admission and entry of the student is at the absolute discretion of the School and will be subject to the availability of a place and the child satisfying the admission requirement at that time. Similarly, placement of the child is also at the absolute discretion of the School and in this regard the School generally takes into consideration various factors, including the child’s age, academic ability, level of achievement relative to the School’s current students, the child’s behaviour etc. 8. The School reserves the right to place the student in a class which the Principal deems academically suitable to the student’s needs at any time while the student is enrolled at the School. This may include a repeat of an academic year. 9. The School reserves the right to suspend or expel a student in a case of misconduct or a serious breach of discipline particularly if this has a detrimental effect (in the opinion of the School) on the other students in the School. 10. In addition to the right to expulsion provided above, the School may require at any time the withdrawal of a student from the School for any reason at the discretion of the Principal. Reasons may include matters related to the student’s inability to participate in or benefit fully from the School’s curriculum or if there is a breach by the parent or child of any matters or things herein stated.