LORIAN MONTESSORI SCHOOL
29, Ola-Salami street, Off Moshalasi Road, Egan, Lagos.
Tel: 08035193958, 08171225884, 08021108038.
REGISTRATION FORM
DAYCARE SECTION
PLEASE USE BLOCK LETTERS THROUGHOUT
NAME OF PUPIL: ______________________________________________________________
SURNAME
FIRST NAME
OTHER NAME
SEX: _____________ DATE OF BIRTH: ______________________ AGE: ________________
NATIONALITY: _________________ STATE: ______________ RELIGION: _____________
FULL NAME AND ADDRESS OF PARENT/GUARDIAN:
________________________________________________________________________________
TEL: OFFICE: ______________________________ HOME: ____________________________
FATHER'S OCCUPATION: _______________________ EMPLOYER: __________________
Do you want your baby to be taken care by the school's doctor in case of emergency?
Yes/No______
Are there any peculiar characteristics of your baby? if any Indicate:
________________________________________________________________________________
Signature of Parent/Guardian: ______________________ Date: __________________________
OFFICIAL USE ONLY
Interviewed by: ________________________
Date: _______________________
Remarks: _______________________________________________________________________
Admission No: ________________________