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1.0 Enrollment Information
State:
*
District:
*
Branch:
*
Year Intake:
*
2024
2025
Enrollment Start:
*
JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUN
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
Previous School:
Preferred Session:
Halfday
Fullday
Mid (3pm)
2.0 Student Details
Name:
*
MyKID:
(Required For Management Purpose)*
Religion:
*
Islam
Buddha
Hindu
Chistian
Other
Race:
*
Malay
Indian
Chinese
Other
Gender:
*
Male
Female
Birth Date:
(Required For Management Purpose)*
Birth Place:
*
Birth Certificate:
*
Favorite Food or Drink:
Illness/Alergic:
*
Other Information:
Immunization:
(Prepare a Copy for Management Purpose)*
Yes
No
3.0 Guardian/Father/Mother Information
First Name:
*
Last Name:
*
IC Number:
*
Email Address:
*
Relation With Student:
Father
Mother
Uncle
Aunty
Grandfather
Grandmother
Brother
Sister
Other
Mobile Phone:
*without (-)
Home Phone:
Home Address (without #):
*
Occupation:
Employer:
Salary:
SELECT SALARY
Less than RM2000
RM2000 - RM3000
RM3000 - RM4000
RM4000 - RM5000
RM5000 and above
Office Address (without #):
Office Phone:
4.0 Spouse Information
First Name:
*
Last Name:
*
IC Number:
*
Email Address:
Relation With Student:
Father
Mother
Uncle
Aunty
Grandfather
Grandmother
Brother
Sister
Other
Mobile Phone:
*without (-)
Home Phone:
Home Address (without #):
Occupation:
Employer:
Salary:
SELECT SALARY
Less than RM2000
RM2000 - RM3000
RM3000 - RM4000
RM4000 - RM5000
RM5000 and above
Office Address (without #):
Office Phone:
5.0 Emergency Contact
First Name:
*
Last Name:
*
IC Number:
Email Address:
Relation With Student:
Father
Mother
Uncle
Aunty
Grandfather
Grandmother
Brother
Sister
Other
Mobile Phone:
*without (-)
Home Phone:
Office Phone:
6.0 How do you know about us :
How do you know about us :
*
Facebook
Instagram
Referred Family/Friends
Radio
Television
Street banner
Google
Billboard and Flyers
Others
I hereby certify that the above information given are true and correct as to the best of my knowledge.
lllllll
I am also understand and agree that my personal data will be stored, processed, and used under Little Caliphs International Sdn Bhd Data Protection Policy.
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