Digital Enrollment – Hooray School

Personal Details/Data Pribadi

Name of child/Nama anak *

First

Last

Age/Umur *

Tahun

Date of Birth/Tanggal Lahir *//

Place of Birth/Tempat Lahir *

Sex/Jenis Kelamin *

Religion/Agama *

Nationality/Kebangsaan

Previous School/Sekolah sebelumnya

Family Details/Data Keluarga

Name of Father/Nama Ayah *

First

Last

Date of Birth/Tanggal Lahir *//

Nationality/Kebangsaan *

Occupation/Pekerjaan *

Home Address/Alamat rumah *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Phone No. /No Telp rumah

Mobile Phone No./No handphone *

Name of Mother/Nama Ibu *

First

Last

Date of Birth/Tanggal Lahir *//

Nationality/Kebangsaan *

Occupation/Pekerjaan *

Home Address/Alamat rumah

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Phone No. /No Telp rumah

Mobile Phone No./No handphone *

Security Measures/Jaminan Keamanan

Please provide the name(s) of any other person (s) who will be dropping off/picking up your child. Please also enclose a photocopy of their identity card./ Mohon memberikan data nama orangyang akan mengantar atau menjemput anak anda, dengan menyertakan fotocopy identitas diri atau KTP orang yang bersangkutan.

Name/Nama *

First

Last

Relationship to student/Hubungan dengan siswa *

Car model and registration number/Jenis kendaraan & no kendaraan *

Student’s Medical Record/Riwayat Catatan Kesehatan Siswa

Student’s name/Nama Siswa *

First

Last

Name of paediatrician/Nama Dokter Anak

Contact details of paediatrician/Detail telp Dokter Anak

Please list any medical issues your child may have./Mohon menginnformasikan tentang berbagai macam riwayat medis yang pernah anak anda alami.

Special health conditions/ Kondisi kesehatan secara spesifik

Allergies/Alergi terhadap

Serious injuries/accidents/Kecelakaan atau luka berat

Medication/Obat-obatan yang pernah diberikan

Operation/Operasi

In the event of an emergency I authorize Hooray School to take whatever action is deemed necessary for the health and safety of my child. Note: Hooray School will make every effort to contact an emergency contact before taking action in a medical emergency.

Pada saat keadaan darurat saya mengizinkan pihak sekolah Hooray School untuk mengambil tindakan apapun yang diperlukan demi kesehatan dan keselamatan anak saya. Dengan catatan: Pihak sekolah Hooray School akan berusaha menghubungi terlebih dahulu no telp darurat tersebut di atas sebelum mengambil tindakan darurat yang diperlukan.

Date / Time *//

Parent’s Signature/Tanda tangan orang tua *

With a digital signature you agree to any data that you have provided for us to use as a complete registration form.

Digital Enrollments

Personal Details/Data Pribadi

Family Details/Data Keluarga

Getting to Know Your Child/Informasi Lebih Lanjut Mengenai Anak Anda

Eating Habits/Kebiasaan pada waktu makan

Toilet Habits/ Kebiasaan menggunakan toilet.

Academic Ability/Kemampuan Akademis

Writing Ability/Kemampuan menulis

Mathematical Ability/Kemampuan matematika

Social Interaction/Interaksi Sosial

Emergency Contact Information/No telp darurat yang bisa dihubungi

Security Measures/Jaminan Keamanan

Student’s Medical Record/Riwayat Catatan Kesehatan Siswa

Please list any medical issues your child may have./Mohon menginnformasikan tentang berbagai macam riwayat medis yang pernah anak anda alami.

In the event of an emergency I authorize Hooray School to take whatever action is deemed necessary for the health and safety of my child. Note: Hooray School will make every effort to contact an emergency contact before taking action in a medical emergency.