AdmitFrm2 - Application for Admission P.O.Box 733, Moshi,...

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Unformatted text preview: Application for Admission P.O.Box 733, Moshi, Kilimanjaro, Tanzania Tel: +255-27-2755004, 2755005, 2751850 Fax: +255-27-2752877 E-mail: admissions@ismoshi.org Web site: http://www.ismoshi.org Arusha Campus P.O.Box 2691, Arusha, Tanzania Tel: +255-27-2505029, 2505030 Fax: +255-27-2505031 Mobile: 0754-740706 E-mail: ismac@ ismac.ac.tz Student’s Name (Underline the name to be used in school) FAMILY       FIRST       Nationality:       Expected Starting Date       Mother Tongue       Date of birth (day/month/year)       To enter Class / Grade       Religion       OTHER       Sex (M / F)   Day/Boarding       Passport Number       Please attach a recent photograph INTERNATIONAL SCHOOL MOSHI PREVIOUS SCHOOLING (most recent first): Classes / Grades       to       Classes / Grades       to       Classes / Grades       to       Classes / Grades       to       Years      to      Years      to      Years      to      Years      to      Name & Address of school       Name & Address of school       Name & Address of school       Name & Address of school       Language used       Language used       Language used       Language used       Knowledge of English (Fluent/Fair/None) List any brothers or sisters in ISM             Probable length of stay in ISM       If you were introduced to ISM by a friend or colleague, please give their name and contact details here:       ADDRESSES Residential Address in Tanzania or East Africa       Business Address       Telephone:       Fax:       E-mail:       Permanent address in home country       Telephone:       Fax:       E-mail:       Emergency contact (in Moshi/Arusha if possible)       Telephone:       Fax:       E-mail:       Telephone:       Fax:       E-mail:       PARENTS Are both parents living?     FATHER                                           Status (Together / Separated / Divorced)       Full Name Nationality Passport Number Mother Tongue Type of employment Position Name of employer Child lives with father / mother / both ?       MOTHER                                           Has your child ever had special educational needs? (Please give details & supporting documents as appropriate)       Is your child in good health? (Give medical details as appropriate)       Parents will be invoiced for fees. If you would also like copies of invoices to be sent elsewhere, please give the name and address:       Conditions for Enrolment and Withdrawal 1. When the parent or guardian who has registered a child for entry into school is offered a place, he/she shall immediately inform the Head whether or not he/she will accept the place. The enrolment fee and refundable deposit (if appropriate) should be paid within one month of the date of the offer letter in order to retain the place. The enrolment fee is not refundable. Once a place has been offered and accepted, the parent or guardian who completed the application form shall be liable to pay the fees by the dates and in the manner required by the school. All fees must be paid in the currency specified by the school. A child in the school shall be presumed to be continuing in the school until such time as notice of withdrawal has been given in respect of him/her. Such notice of withdrawal must be given in writing and delivered to the Head personally or by registered post. Unless such notice of withdrawal is given at least 30 school days (excluding weekends and school holidays) before the child is withdrawn from school, the parent or guardian shall be required to pay an additional fee of ½ term’s tuition (and boarding where applicable) in lieu of notice. Fees are not refundable in cases of absence through illness, vacation or leave, suspension or expulsion. 2. 3. 4. 5. Agreement I understand that the insurance of my child against accident, loss of property or refund of fees in case of illness is my own responsibility. I hereby absolve International School Moshi Ltd of all responsibility for accident, illness or loss of personal property sustained by my child during the school year. I give permission for the Head to seek medical advice and accept medical or surgical treatment for my child in the event of illness or accident. I understand that in an emergency I will be notified as soon as possible. I undertake to abide by the conditions for enrolment and withdrawal set out above and I accept the school’s regulations and requirements. I understand that the school fees must be paid in the currency and manner prescribed by the school. I agree to pay school fees in advance each term on or before the date specified for payment. I certify that the information supplied on this form is correct in every detail. Parent’s / Guardian’s Signature: Signed on behalf of International School Moshi Ltd. This application form must be accompanied by 1. a copy of the child’s birth certificate, 2. a copy of his/her most recent school report (where applicable), 3. a recent passport-sized photograph. Date:       Date: ...
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This note was uploaded on 05/19/2011 for the course ECON 201 taught by Professor Williams during the Winter '08 term at LA Tech.

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