CORONATION PREP ACADEMY SCHOOL ONLINE ADMISSION FORM

Complete the application carefully before submitting.

Birth Certificate

Upload Birth Certificate

Child's Information

Surname

Other Name

Date of Birth

Gender

Religion

Nationality

State of Origin

Local Government Area

School Last Attended

Class Completed

Telephone Number

Father's Details

Father's Name

Occupation

Telephone Number

Email Address

Residential Address

Office Address

Mother's Details

Mother's Name

Occupation

Telephone Number

Email Address

Residential Address

Office Address

Child Health Information

BCG Immunization

Polio Immunization

Measles Immunization

Is the Child Physically Challenged?

If Yes, Specify

Known Allergies / Medical Conditions

Permission to Administer First Aid

Yes

Emergency Contact

Guardian / Emergency Contact Name

Telephone Number

Residential Address

Declaration

I certify that the information provided in this application is true and correct.

CORONATION PREP ACADEMY SCHOOL ONLINE ADMISSION FORM

Admission Information

Passport Photograph

Birth Certificate

Child's Information

Father's Details

Mother's Details

Child Health Information

Emergency Contact

Declaration

CORONATION PREP ACADEMY

ADMISSION ACKNOWLEDGEMENT SLIP