Consent Form

Surname*

First Name*

Other Names

Date of Birth*

Email Address*

Name of Current School*

Address of Current School*

Current Class/Grade*

Date of Admission*

Date of Completion*

Subject/Course Offered at present school

Grade

Proposed programs of study after completion of High School in order of preference (for career guide and course selection)

Has student been identified as exceptional (IEP)?YESNO

Title

Surname*

First Name*

Other Names

Home Address*

Mobile Telephone*

Email Address*

Residence Telephone

Business Telephone

Transcript 1*

Transcript 2

Transcript 3

WASSCE Result 1*

WASSCE Result 2

Letter of Intent

International Passport*