TO BE FILLED BY THE PARENT / GUARDIAN

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Frederick Johnston
8 years ago
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1 PO Box Makueni ADMISSION FORM ADMISSION OF PUPIL: YEAR Name of the pupil: I have the pleasure to inform you of your admission into this school as a day scholar / boarder in class you are required to report on TO BE FILLED BY THE PARENT / GUARDIAN Pupil s name: Date of birth: (Attach copy of birth certificate) Nationality: Religion Denomination Previous school attended Year: Up to class: Interview Marks Attained: out of: Class admitted: Previous Class last year: NEXT OF KIN Fathers Name: ID No. : Occupation: Place of work: Mobile No: 1 2 Postal address P.O Box: Code: address: or Physical address: Country: County District: Division: location: Town: Road: Street: Estate/village: House no.: Near (Exact location: Mothers Name ID No.: Occupation: Place of work: Mobile No: 1 2 Postal address P.O Box: Code: address: or Physical address: Country: County District: Division: location: Town: Road: Street: Estate/village: House no.: Near (Exact location:

class: Interview Marks Attained: out of: Class admitted: Previous Class last year: NEXT OF KIN Fathers Name: ID No. : Occupation: Place of work: Mobile No: 1 2 Postal address P.

2 Guardian / sponsor Name: ID No. Relationship to the pupil: Occupation: Place of work: Mobile No: 1 2 Postal address P.O Box: Code: address: or Physical address: Country: County District: Division: location: Town: Road: Street: Estate/village: House no.: Near (Exact location: Rubber stamp/ sign: Date: ON THE ADMISSION DAY Bring this form filled and dully signed with the following; i. Two recent passport size photos of the pupil ii. A certified medical certificate as per attached form iii. Birth certificate (copy) iv. Previous School latest report form POINTS TO NOTE BEFORE ADMISSION The school does not provide special diet. Pupil s absenteeism is not encouraged in this school except on serious cases which are beyond control. Pupils are not allowed to keep money in their pockets or boxes. Pupils are not allowed to keep food or other edibles in the dormitories, lockers or anywhere in the school compound. All the pupils must be in the classroom when the lessons are on. All pupils should dress as per the school uniform code. Boys should maintain short hair. To be shaved every two weeks while girls shall be plaited lines only after every three weeks. All assignments and exams given in the school must be done by the pupils. Parents should buy and provide all necessary learning materials as may be required from time to time for their pupils. VISITING OR REQUEST TO SEE CHILDREN AT SCHOOL. Pupils will strictly be visited by the persons who appear in the admission register or on the form provided by the school. Pupils will only be seen on the school s set days: i.e. visiting days, parent days or on parent s request. Incase of picking the pupil, the parent or guardian should make prior arrangements with the school. The person to pick the pupil home must obtain a leave out form before the pupil leaves the school compound. This will be the procedure whether the pupil is going for treatment, school fees or for any function.

: Near (Exact location: Rubber stamp/ sign: Date: ON THE ADMISSION DAY Bring this form filled and dully signed with the following; i. Two recent passport size photos of the pupil ii.

3 PARENT DECLARATION FOR VISITING OF PUPILS I / we the parent(s) of Adm. No.. Have authorized the under mentioned person to visit / take my child on my / our behalf. 1. ID NO... MOBILE NO ID NO. MOBILE NO ID NO. MOBILE NO ... He / she is best known to me and I trust him / her with my child NAME ID NO.. SIGNATURE... DATE Declaration by the pupil: I, Adm. No. class do hereby agree to abide by the rules and regulations set out on this admission letter and any other rules that the school management may deem fit for my wellbeing while in the school compound. Signed: by Date Declaration by the parent / guardian / sponsor. I, ID No Relationship to the pupil and I, ID No relationship to the pupil do hereby agree to abide by the rules and regulations set out on this admission form and that we guarantee to pay in full the school fees for (pupils name) class Adm. No As may be set by the school management from time to time. Signed: By: Date: Signed: By: Date:

class do hereby agree to abide by the rules and regulations set out on this admission letter and any other rules that the school management may deem fit for my wellbeing while in the school compound.

4 PO Box Makueni PARENTS / GUARDIANS Write any information you would like the school to know about your child. Name Class.. Adm no.... e.g. My child... Is playful... Has breathing system problem.... Epileptic... Has been operated on... Allergic to... This information will help the school to know how to deal with the child and the problem when it arises. If no problem write N/A or not aware... PO Box Makueni MIDICAL CERTIFICATE MEDICAL CERTIFICATE YEAR... I... have examined today... and he / she is fit / unfit to join school. Signed. Date... Doctors name Official stamp.....

.. This information will help the school to know how to deal with the child and the problem when it arises. If no problem write N/A or not aware.

5 REQUIREMENTS FOR BOARDERS Bring 2 (two) blankets; I pair of light blue sheets. 1(one) pair of black leather shoe. (short heeled) A pair of canvas shoes - Bata bullet P.E uniform. (yellow /maroon) 2 (two) spring files, covers, pencils, biro pens and geometrical set.(6-7 oxford) Boys: - 2 (two) shorts, 2 (two) shirts, a tie, 2 (two) sweaters (a full sweater and a wind breaker), socks and a pajama. Girls:- 2 (two) tunics, 2 (two) blouses, a tie, 2 (two) sweaters,(full sweater and wind breaker)socks, night dress, lesso, bloomer and wrapper. A washing basin plastic (boarders A big towel and a face towel (boarders) A 10 (ten) litres jerican or a bucket (boarders) A spoon, plate and a cup (aluminum ) Other personal effects soap, kiwi tooth brush and paste, toilet papers, sanitary towels for girls etc. A wooden box with hardwood on top and bottom 26½ x 16 x 8½ A mattress 6 x 2 x 3, mosquito net. 6ft x 2ft x 3 Track suit Pocket money to be kept by the school. REQUIREMENTS FOR DAYSCHOLARS 1 (one) pair of black leather shoe. (short heeled) A pair of canvas shoes - Bata bullet P.E uniform. (yellow /maroon) 2 (two) spring files, covers, pencils, biro pens and geometrical set.(6-7 oxford) Boys: - 2 (two) shorts, 2 (two) shirts, a tie, 2 (two) sweaters (a full sweater and a wind breaker) and socks. Girls: - 2 (two) tunics, 2 (two) blouses, a tie, 2 (two) sweaters,(full sweater and wind breaker)and socks. A spoon, plate and a cup (aluminum Track suit Uniform available at the school at, a set for a Girl kshs 7,500/= Boy kshs 6,500/= exclusive of shoes Track suit kshs 1700 Exercise books will be provided by the school. SIGN..Date B.M. WAEMA

(6-7 oxford) Boys: - 2 (two) shorts, 2 (two) shirts, a tie, 2 (two) sweaters (a full sweater and a wind breaker), socks and a pajama.

6 PO Box Makueni FEES STRUCTURE FOR THE YEAR 2015 PAYMENT TERMS AND CONDITIONS 1. For New pupils there is an ADMISSION FEE of Ksh.5, 000/= payable on admission. 2. School fees is payable IN FULL on or before opening day. 3. School fees is payable to the school account in the EQUITY BANK, WOTE BRANCH, ACCOUNT Number , Account name- THE MAKUENI MIXED DAY AND BOARDING SCHOOL LTD. This can be paid in ANY Equity bank countrywide. 4. Payment method is either by banking slip for Cash banked directly to our Bank Account at Equity bank or Bankers Cheque. No cash or Personal Cheques will be accepted at the school. Please indicate the Name of Pupil, Class and Admission number on the banking slip or cheque. 5. School fees is subject to change without notice and is NON-REFUNDABLE. 6. Do not sent school fees to individuals or Mpesa numbers, the school will not be responsible for any losses or inconveniencies caused by this method.

This can be paid in ANY Equity bank countrywide. 4. Payment method is either by banking slip for Cash banked directly to our Bank Account at Equity bank or Bankers Cheque.

Applicants are requested to send the application along with DD of Rs.100/- in favour of Gautham School of Nursing.

Applicants are requested to send the application along with DD of Rs.100/- in favour of Gautham School of Nursing. DUPLICATE APPLICATION FORM TO BE PRINTED IN APPROPRIATE COLOURS (USING A COLOUR PRINTER)