Registration Form

Admission form into HHCJ Assumpta Girls' Model Secondary School.

Section A

Firstname*:

Lastname*:

Othername:

Home Address *:

Date of Birth *:

Sex :

Blood group of the pupil :

Father's Name :

Father Occupation :

Telephone no :

Father's office address :

Mother's Name :

Mother's Occupation :

Telephone no :

Mother's office address :

Section B

Name of previous school attended : i :

ii :

iii :

Last class attended :

Upload scan copy result of last promotion Examination :

Class for which admission is sought :

Section C

Name, Address and Telephone no of person to be contacted in case of emergency :

Does the student have any form of allergy? :

Does the child have any form of allergy? If yes, please give details :

Name and Address of student's sponsor :

State any other information you have about the child :

Section D

Proof of residence :

Photocopies of birth :

HHCJ Assumpta Girls' Model Secondary School

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HHCJ Assumpta Girls' Model Secondary School
TEL: 0803 573 8146
EMAIL: info@hhcjassumptagirls.com.ng