Enquiry Form

Prime Montessori School

23, New Road, off Community Road, Satellite Town, Lagos

Registration / Enquiry Form

I wish to register my child/ward in Prime Montessori Nursery/Primary School and undertake to comply with its rules and regulations, as set out in the School's Prospectus and Rules and Regulations Booklet.

A. Pupil biodata

Child surname * Child middle name Child first name * Date of birth * Place of birth * Nationality * Sex * School(s) last attended (where appropriate) Class last read (where appropriate) LASGEM'S number (where appropriate)

B. Father's biodata

Name of father * Occupation * Contact / office address * Home address * Email address * Telephone number *

C. Mother's biodata

Name of mother * Occupation * Contact / office address * Home address * Email address * Telephone number *

D. Family doctor / hospital

Name of family doctor (if any) Name and address of family hospital Telephone number of family doctor / hospital

E. Medical history / health of child

Speech development * Sight * Is your child / ward a sickler? * Is your child / ward asthmatic? * Any other medical condition the school should know about

F. Emergency contact

Contact name * Relationship (father, mother, guardian, etc.) * Home address * Office address Telephone number *

G. Affirmation

Name of responsible parent / guardian * Relationship (father, mother, guardian, etc.) * Home / contact address * Telephone number * Typed signature (full name) * Date *

By submitting this form, I agree to place the child/ward named above in Prime Montessori Nursery and Primary School and to be responsible for payment of school fees and associated expenses. The typed signature is my electronic acknowledgement.

I confirm that the information is correct and agree to the affirmation above.

This form contains personal and medical information about a child. Information is stored privately for school enquiry and accessed by authorized WordPress Administrators, Editors and Authors only. Contact the school to request corrections or deletion in accordance with applicable law.