Admission Form

Admission Admission Form

For further information please call:

Preschool and Kindergarten
021-88865770, 0838 7833 1919 Primary
021-88987306, 0851 0035 6828 Junior High School
021-8944 1151, 0821 1477 5734

Admission Form

Student Information

Child’s Full Name

Date of Birth

Place of Birth

Gender

Passport / Birth Certificate No

Religion

School of Origin

Program

Family Information

Father's Name

Passport / KTP No.

Father's Home Address

Phone Number

Nationality

Occupation

Religion

Mother's Name

Passport / KTP No.

Mother's Home Address

Phone Number

Nationality

Occupation

Religion

Emergency Contact (Name/ Address/ Phone No / Relationship ) :

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