Dornnie Private School
Registration Form
Child's Data
Form Type:
choose form type
Daycare
Nursery and Primary
Surname:
Other name:
Sex:
Male
Female
Date of Birth:
Age:
Denomination:
Religion:
Nationality:
State of Origin:
Previous Schools (If Any):
Immunization
BCG:
yes
no
DTP (1st Dose):
yes
no
DTP (2nd Dose):
yes
no
DTP (3rd Dose):
yes
no
Measles:
yes
no
Booster Doses:
yes
no
Any Other:
Medical History
Blood Group:
Genotype:
Height:
Weight:
Is the Child Asthmatic:
yes
no
Is the Child a Sickler:
yes
no
History of Convulsion:
yes
no
Any Sensitivity or Allergies:
Any Disability (If any please state nature):
Is He/She On Any Form Of Medication/Treatment:
Name of Family Doctor (If Any):
Doctor's Contact Address:
Doctor's Phone Number:
Parent's Data
Father's Name:
Residential Address:
Phone Number:
Email:
Occupation:
Office Address:
Any Other Place of Contact:
Mother's Name:
Mother's Residential Address:
Mother's Phone Number:
Mother's Email:
Mother's Occupation:
Mother's Office Address:
Mother's Other Place of Contact:
Name of Child's Regular Collector:
File Uploads
Child's Passport:
Child's Birth Certificate:
Child's Regular Collector:
Pay and Submit
