Child's Name *

First Name

Last Name

Grades (Age requirements by July 1)

PreNursery 1 (1 year 11 months - 2 years and 10 months old)

PreNursery 2 (2 year 11 months - 3 years and 10 months old)

Kindergarten 1 (3 year 11 months - 4 years and 10 months old)

Kindergarten 2 (4 year 11 months - 5 years and 10 months old)

Elementary (SD) ( Grade 1 must be at least 5 year 11 months)

Middle School (SMP)

Phone *

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Contact Person *

Parents/Guardian

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country