INSTRUCTION
i. Please read through all instruction carefully before filling this form that is in eight section: A, B, C, D, E and F
ii. Fill in every information as requested
iii. Failure to complete the form properly may invalidate your admission

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First Name *

Middle Name

Last Name *

Gender *

Date of Birth *

Age

State of Origin *

Last School Attended *

Date *

Nationality *

Contact Address *

Residential Address (Check box if same with contact address)

Permanent Home Address (Check box if same with contact address)

Class Seeking Admission *

Number of Siblings *

Position in the Family *

SECTION B: PARTICULARS OF PARENT/GUARDIAN

Title *

Name *

Contact Number *

Occupation *

Marital Status *

Religion *

Email *

Contact Address *

Residential Address

Permanent Home Address

Mother's Name

Contact Address of Local Guardian

SECTION C: MEDICAL REPORT

(A) TEST

1. Chest X-Ray (Film of the X-ray to be brought to school)

2. BLOOD TEST

HB%

GENOTYPE

Sickling Test *

Blood Group *

Other Comments (if any) *

3. VISUAL ACUITY

(B)

1. Is the Pupil/Students suffering from any underlisted health problem?

Asthma

Epilepsy

Physical Disability

2. Any History of Surgery (if Yes give details):

3. What other information would you want the school to be aware of that would help in the understanding the Pupil/Student’s Medical Condition?

4. Full Name of Medical Doctor

SECTION E: OATH OF ALLEGIANCE BY STUDENT

I, on admission into St. Mary Dedication British Montessori School solemnly and sincerely promise and declare that I will pay due respect and obedience to the Management team and other officers of the institution and that I will faithfully observe and regulations which may from time to time be issued by them for the good order and governance of the institution.

SECTION F: ENTRANCE EXAMINATION CENTER

The entrance examination into the school shall take place in Benin City at St. Mary Dedication British Montessori School Opposite Benin Golf Course Reservation Road, G.R.A, Benin City.

ADMISSION FORM FOR MONTESSORI

SECTION A: PERSONAL DATA

INSTRUCTION
i. Please read through all instruction carefully before filling this form that is in eight section: A, B, C, D, E and F
ii. Fill in every information as requested
iii. Failure to complete the form properly may invalidate your admission

SECTION B: PARTICULARS OF PARENT/GUARDIAN

SECTION C: MEDICAL REPORT

(A) TEST

(B)

SECTION D: PARENT'S/GUARDIAN'S DECLARATION

SECTION E: OATH OF ALLEGIANCE BY STUDENT

SECTION F: ENTRANCE EXAMINATION CENTER

ADMISSION FORM FOR MONTESSORI

SECTION A: PERSONAL DATA

INSTRUCTION i. Please read through all instruction carefully before filling this form that is in eight section: A, B, C, D, E and F ii. Fill in every information as requested iii. Failure to complete the form properly may invalidate your admission

SECTION B: PARTICULARS OF PARENT/GUARDIAN

SECTION C: MEDICAL REPORT

(A) TEST

(B)

SECTION D: PARENT'S/GUARDIAN'S DECLARATION

SECTION E: OATH OF ALLEGIANCE BY STUDENT

SECTION F: ENTRANCE EXAMINATION CENTER

INSTRUCTION
i. Please read through all instruction carefully before filling this form that is in eight section: A, B, C, D, E and F
ii. Fill in every information as requested
iii. Failure to complete the form properly may invalidate your admission