| Please use block letters
throughout |
| |
| Name of
Student: |
|
|
|
|
| First Name: |
|
GENDER: |
MALE
|
| Middle Name: |
|
|
FEMALE
|
| Last Name: |
|
|
|
|
| Date of Birth: |
|
|
|
|
| Citizenship: |
|
RACE:
(M'sians
only) |
MALAY |
|
| Name of
Parent: |
|
CHINESE |
|
| Father: |
|
|
INDIAN |
|
| Mother: |
|
|
OTHERS |
|
| Citizenship of
Parent: |
|
|
|
|
| Father: |
|
|
|
|
| Mother: |
|
|
|
|
Occupation
Sector:
|
|
|
|
|
Father:
|
|
|
|
|
Mother:
|
|
|
|
|
| Occupation Position : |
|
|
|
|
Father:
|
|
|
|
|
| Mother: |
|
|
|
|
| Home
Address: |
|
|
|
|
| |
Postcode: |
|
|
|
| Contact Details :
|
|
|
|
|
| Home Tel: |
|
|
|
|
| Office Tel: |
|
|
|
|
| Mobile Tel: |
|
|
|
|
| Email: |
|
|
|
|
| No. of Children in
Family: |
|
|
|
|
| |
|
|
|
|
| |
|
|
|
|
| Siblings
(applying to / currently in elc) |
|
Name :
Year :
|
Date of Birth : |
|
|
Name :
Year :
|
Date of Birth : |
|
|
Name :
Year :
|
Date of Birth : |
|
| Student's
Current School: |
|
|
|
Location of Current
School:(state country only)
|
|
|
| Student's
Current Year/Level: |
|
|
|
|
| Seeking Admission
for: |
Term 1 September - December
|
yyyy |
|
|
| |
Term 2 January -
April |
yyyy |
|
|
| |
Term 3 April -
July |
yyyy |
|
|
| Completed
By: |
|
|
|
|
| Name: |
|
|
|
|
| Date: |
|
|
|
|
| |
|
|
|
|
