APPLICATION FOR ADMISSION CHILD INFORMATION Date: Student’s Name First: Middle: Last: Date of Birth: Current Age: Nationality: Sex: / / M F Years Months Primary (First) Language: Second Language: Does your understand and/or speak English? Yes No Does your child understand and/or speak Arabic? Yes No Siblings currently at ECLC: Sibling Name/s: Status: Class: Applied Yes No Registered PARENT INFORMATION Father’s Name: Mother’s Name: Nationality: Nationality: Occupation: Occupation: Employer: Employer: CONTACT INFORMATION (Please note: the majority of the ECLC correspondence will be sent via email) Residence Telephone: Father’s Mobile: Mother’s Mobile: Father’s Office Telephone: Mother’s Office Telephone: Father’s Mother’s Street Address: P.O. Box: City: ENROLLMENT PREFERENCES Enrollment Dates: Semester 1 (September/January) Semester 2 (February/June) Enrollment Days/Timings: (Please make a selection) Days per week: Preferred days: (Infants 6-12 months) ONLY Preferred Timings: 3 days per week Sunday Wednesday Children (1-4 years) Infant (6-12 months) (infants 6–12 months) 7:30am 5 hours: –12:30pm ……………. Monday Thursday 5 days per week 7:30am 3pm 7.5 hours: – ………….. (children 1–4 years) Tuesday 7:30am 5:30pm 10 hours: – ……………
APPLICATION FOR ADMISSION CHILD INFORMATION Date: Student’s Name First: Middle: Last: Date of Birth: / / Current Age: Years Months Nationality: Sex: M F Primary (First) Language: Second Language: Does your understand and/or speak English? Yes No Does your child understand and/or speak Arabic? Yes No Siblings currently at ECLC: Yes No Sibling Name/s: Status: Applied Registered Class: PARENT INFORMATION Father’s Name: Mother’s Name: Nationality: Nationality: Occupation: Occupation: Employer: Employer: CONTACT INFORMATION (Please note: the majority of the ECLC correspondence will be sent via email) Residence Telephone: Father’s Mobile: Mother’s Mobile: Father’s Office Telephone: Mother’s Office Telephone: Father’s Mother’s Street Address: P.O. Box: City: ENROLLMENT PREFERENCES Enrollment Dates: Semester 1 (September/January) Semester 2 (February/June) Enrollment Days/Timings: (Please make a selection) Days per week: Preferred days: (Infants 6-12 months) ONLY Preferred Timings: 3 days per week (infants 6–12 months) 5 days per week (children 1–4 years) Sunday Wednesday Monday Thursday Tuesday Children (1-4 years) 7:30am –12:30pm 7:30am – 3pm 7:30am – 5:30pm Infant (6-12 months) 5 hours: ……………. 7.5 hours: ………….. 10 hours: ……………
ECLC_APPLICATION_FORM-final-fall2012.docx