A.Personal Details:
Name:
Date of birth:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
NRIC\Birth Certificate Number:
(Please submit photocopy of birth certificate to the center)
Gender:
Boy
Girl
Number of Sibling:
Address:
Home Number:
B. Parents / Guardian / Spouse Background:
Father's Name:
NRIC:
Occupation:
Mobile Number:
Office Address:
Phone Number:
E-mail:
Mother's Name:
NRIC:
Occupation:
Mobile Number:
Office Address:
Phone Number:
E-mail:
Total Income:
RM30 000 and below
RM 30 000 to RM 60 000
RM 60 000 to RM 80 000
RM 80 000 to RM 100 000
RM 100 000 to above
C. Habits and personality
Please describe about your child or any specific information or problem which you would like the school to know:
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