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Britishschoolquito.edu.ec

Application Form – Primary
Years 2 –6
D ate: _______________
Applying for:
DD / MM / YY
Application No: ______
A cademic year 20____20___
APPLIC ANT:
Last Name
First Name
Middle Name
Date of b irth
: ____/______/__
Age: ____ _____
ID No. _________________________________ Passport No. _________________
f Birth: __________________________
Nationality: ___________________
Last Sch ool Year: _______________________
Home Address:
Home Te lephone: ______________________________
First Language: _________________________

Other lan
guages spoken: _________________
English l evel: Basic
e of brother /sister
Age School Year
Current School
__________ _______________________________ ___________ _______________________________ SCHOOLS ATTENDED:

f Institution - City
School Year
Academic Year
Language of Instruction
f Institution - City
School Years
Academic Year
Language of Instruction
_______________
__________
____________
____________________
Name of Institution - City
School Years
Academic Year
Language of Instruction
f Institution - City
School Years
Academic Year
Language of Instruction
AL INTERESTS
Hobbies: ___________________________________________________________________________________
Musical Instruments: _________________________________________________________________________
_____________________________________________________________________________________ PARENTS STATUS
Married Divorced
Other Specify_______________________
STUDENT LIVES WITH:
Mother & Father
Grandparents
Other Specify: ______________________________
CONTACT ADDRESS IN COUNTRY OF CURRENT RESIDENCE:

Home ad dress: ______________________________________________________________________
ne: _______________Mobile__________________Email______________________________
R INFORMATION
ecommended to you The British School, Quito?
A British School Family
Names: _____________________________________________
d’s Playgroup
Name of the Institution: ________________________________
Newspaper Publication
Which publication?__________________________________
e Publication
Other, please specify___________________________________
INFORMATION
The legal guardians of the applicant are:
Stepfather Stepmother
Others Others
(Please specify)
(Please specify)
SUPPLEMENTARY SERVICES
TRANSPORTATION: YES NO
MEALS: YES NO
Round tri
way trip:
Location: _________________________________
NCIAL INFORMATION:
y payments, Matriculation or additional fees are paid by:
If this is the case, please complete the following:
Name of the Company: _________________________________________________________________
R.U.C.: ______________________________________________________________________________
Address: ____________________________________________________________________________
Telephone: ___________________________________________________________________________
Contact: _____________________________________________________________________________
STUDENT´S INFORMATION
e complete this form as fully as possible. our child ever experienced difficulties setting in at a new school? (If yes, please give details) 2. Has y our child ever had any behavioral difficulties? (If yes, please give details)
he child been asked to withdraw from any school? (If yes, please give details) he child been responsible for any disciplinary incident in any school, being this related to academic violation or attitude that resulted into a trail period, suspension, voluntary expulsion or definite expulsion from the institution. (If yes, please give details) he child failed a school year? (If yes, please give details) 6. Has the applicant been promoted in a school year without attending? (If yes, please give details)
7. Has the applicant received any of the following services in any school?
Advanced classes for gifted children (If yes, please give details) Academic support / special needs (If yes, please give details) Emotional/social support (If yes, please give details) 8. Do yo u have any concerns about your child´s social development? (i.e. does he/she have difficulty
making friends? Does he/she only have friends who are older or younger?) (If yes, please give details) TANT ADMISSIONS NOTICE
The British School, Quito uses a selective admissions policy for all national and international students. Students with learning difficulties, requiring learning support or intensive English Language support, will be admitted if there are s paces in the Learning Support or English as an Additional Language (EAL) Departments and the student In this c ontext, we kindly request that you provide the BSQ with all pertinent documentation about any particular special l earning need that your child may have. Failure to do so may result in the student concerned being withdrawn during the admissions process or after the student has commenced classes. Legal Representative Signature
LEGAL GUARDIANS INFORMATION
FATHER’S INFORMATION
MOTHER’S INFORMATION
Full Name:
Full Name:

Nationality:

Nationality:

ID No. / Passport:

ID No. / Passport:

Educational Qualifications:

Educational Qualifications:

Occupation:

Occupation:
Name of Emplo
Name of Employer:
Marital Status:
Marital Status:
Home Address:
Home Address:
Home Telephon
e / Mobile:
Home Telephone / Mobile:
E-mail address:
E-mail address:
Office Telephon e:
Office Telephone:
Office e-mail address:
Office e-mail address:
How long do you envisage staying in Quito?
Is there any spe cial information that the school should know?
IMPORTANT NOTE
hroughout the school year in ten equal monthly payments. They should be paid within the first 10 onth. Absence or illness does not reduce payment as the fee is based on year-round costs. If the an wishes to withdraw their child from the school they should communicate this in writing to the a month´s notice. Otherwise, the monthly fee is still applicable. Parents who have an employer paying school fees on their behalf are nonetheless responsible for ensuring that those fee payments are kept current and are also responsible for any outstanding payments for the school. an I accept the above mentioned terms and conditions. Legal R epresentative Signature
THE BRITISH SCHOOL, QUITO
STUDENT PERMISSION FORM
I ________________________ parent/guardian of ___________________________hereby give permission for the following medications to be administered by the BSQ nurse should the need arise. 1. Insect repellent ……………………………………………………………. 2. Balm to soothe insect bites/stings………………………………. 3. Ibuprofen……………………………………………………………………. 4. Paracetamol…………………………………………………………………. 5. Cream for bruises/bumps…………………………………………. 6. Disinfectant to clean scratches or cuts. Photographs
I______________________________, parent/guardian of _________________________Hereby give permission for photographs taken by the BSQ to be used in promotional materials and/or the school website.
Excursions

I________________________, parent/guardian of ______________________________Hereby give permission for my child to attend School excursions and incursions within a 20km radius of the School.

Source: http://www.britishschoolquito.edu.ec/web/imagesFTP/Admissions/PRIMARY%20FORM%20corrected.pdf

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ANTES DE USAR O PRODUTO LEIA O RÓTULO, A BULA E A RECEITA E CONSERVE-OS EM SEU PODER. “É OBRIGATÓRIO O USO DE EQUIPAMENTOS DE PROTEÇÃO INDIVIDUAL. PROTEJA-SE” “É OBRIGATÓRIA A DEVOLUÇÃO DA EMBALAGEM VAZIA.” CLASSIFICAÇÃO TOxICOLÓGICA III - MEDIANAMENTE TÓxICO CLASSIFICAÇÃO QUANTO AO POTENCIAL DE PERICULOSIDADE AMBIENTAL III - PRODUTO PERIGOSO AO MEIO AMBIENTE

New student health form 2013

All students newly admitted to Dwight School Seoul must complete and submit this health form prior to the first day of school. Page 3 of this form must be completed by a physician. The family is welcome to select a physician outside of Korea. If any of the information provided on this form changes during the school year, please notify the school Nurse immediately. Student Information Medica

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