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Application for Admission
Secondary School

Name of Aplicant
Last name
 
Mother's last name
 
First name
 
Middle Initial
 
Sex    
Male
 
Female
 
Date of Birth
Month
 
Day
 
Year
 
Place of Brirth
City
 
Country
 
Age
 
Citizenship
   
Country
 
Name of parent/ guardian financially responsible for student:
Last name
 
First name
 
Occupation
 
Home Adrress
 
Cantón
 
Distrito
 
Telephones    
Residence
 
Office
 
Celular
 
Fax
 
Contact    
Mailing Address
 
PO-Box
 
e-mail
 
Name of second parent
Last name
 
First name
 
Occupation
 
Home Address
 
Cantón
 
Distrito
 
Telephones    
Residence
 
Office
 
Celular
 
Fax
 
Contact    
Mailing Address
 
PO-Box
 
e-mail
 
Parent's Status
 
Deceased
  Father Mother
Family members living with applicant
   
Name of school siblings are currently attending
1.- Name
 
Grade
 
2.- Name
 
Grade
 
3.- Name
 
Grade
 
Name and emergency phone
Name
 
Telephones    
Residence
 
Office
 
Celular
 
Information of last (or current) school student attended
Name
 
Phone
 
Address
 
Last grade
 
Elegible for
 
Bus service
  Yes No
     

 

Dirección:
800 mts sur de la estación de servicio Hnos Montes, Santa Ana, carretera a Salitral, contiguo Aldea SOS.

 

Teléfonos:
2282-6512
2203-8128

e-mail: info@kiwicr.com
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