KIDZ WORLD
APPLICATION FORM
2015 - 2016
DETAILS OF STUDENT
FAMILY NAME
FIRST NAME
MIDDLE NAME
MALE/FEMALE
DATE OF BIRTH (DD/MM/YY)
NATIONALITY (According to Passport)
PLACE OF BIRTH
(COUNTRY)
RELIGION
LANGUAGES SPOKEN AT HOME
CPR NUMBER
DATE ISSUED
EXPIRY DATE
PASSPORT NUMBER
DATE ISSUED
EXPIRY DATE
PREFERRED
ADMISSION DATE
BROTHERS + AGES
SISTERS + AGES
LOCAL HOME ADDRESS IF DIFFERENT FROM STUDENT
PO BOX ADDRESS
Flat/Villa/House No
Building No
Road No
Block (Area) No
Block (Area) Name
PREFERRED CONTACT EMAIL ADDRESS
Villa No: 1522, Road No: 2733, Block No: 327, Adliya, Manama, Kingdom of Bahrain,
PO BOX 26355 Tel: 17715050, Fax: 17715048, www.kidzworldkindergarten.com
KIDZ WORLD
APPLICATION FORM
2015 - 2016
DETAILS OF PARENTS OR GUARDIANS
FATHER (GUARDIAN) FAMILY NAME
FIRST / MIDDLE NAME
Title: (Dr, Mr Etc):
NATIONALITY
NAME OF EMPLOYER
OCCUPATION
HOME NUMBER
MOBILE NUMBER
OFFICE NUMBER
WORK MOBILE NUMBER
EMAIL
WORK EMAIL
MOTHER (GUARDIAN) FAMILY NAME
FIRST / MIDDLE NAME
Title: (Dr, Mrs Etc):
NATIONALITY
NAME OF EMPLOYER
OCCUPATION
HOME NUMBER
MOBILE NUMBER
OFFICE NUMBER
WORK MOBILE NUMBER
EMAIL
WORK EMAIL
Villa No: 1522, Road No: 2733, Block No: 327, Adliya, Manama, Kingdom of Bahrain,
PO BOX 26355 Tel: 17715050, Fax: 17715048, www.kidzworldkindergarten.com
KIDZ WORLD
APPLICATION FORM
2015 - 2016
STUDENT HEALTH AND MEDICAL HISTORY
CONDITION
YES NO
CONDITION
Diabetes
Measles
Asthma
Mumps
Epilepsy
Hepatitis
Fits and / or Convulsions
Sickle Cell Anaemia
Persistent Headaches
Haemophilia / Thalacaemia
Chicken Pox
Congenital Heart Disease
German Measles / Rubella
Bone / Joint Disease
Allergies
Serious Operations / Hospitalisation
Encephalitis
Meningitis
Kidney Diseases
Ear Infections / Hearing Problems
Poliomyelitis
Stripy Throat
Rheumatic Fever
Tonsillitis
Scarlet Fever
Tuberculosis
Other
Whooping Cough
YES NO
Details and Dates;
______________________________________________________________________________________
Is there any other information that the teachers may need about your child?
Villa No: 1522, Road No: 2733, Block No: 327, Adliya, Manama, Kingdom of Bahrain,
PO BOX 26355 Tel: 17715050, Fax: 17715048, www.kidzworldkindergarten.com
KIDZ WORLD
APPLICATION FORM
2015 - 2016
Immunisation Record
Can you please provide the school with a copy of the immunisation records for your child / children? This is
a requirement set by the Ministry of Health and is therefore important that you supply us with the relevant
information. If you do not have the original vaccination record, please complete the vaccination sheet below
and have it certified by your family doctor.
Name of Child
AGE
Date of Birth___/___/___
VACCINE
At Birth
2 Months
4 Months
6 Months
12 Months
18 Months
2 Years
5 – 6 Years
BCG for non-Bahraini newborns
DTP + HB + IPV (Hexavalent)
Conjugated Pneumocoal
Rota Vaccine (Oral)
DTP + HB + Hib (Penta)
OPV
Conjugated Pneumocoal
Rota Vaccine (Oral)
DTP + HB + Hib (Penta)
OPV
Conjugated Pneumocoal
MMR
Hepatitis A
DTP + OPV
Hepatitis B + Hib
Meningococcal
Hepatitis A
DTaP
OPV
MMR
OTHER VACCINATIONS RECEIVED
DOSE
DATE
RECEIVED
Single Dose
1st Dose
1st Dose
1st Dose
2nd Dose
2nd Dose
2nd Dose
2nd Dose
3rd Dose
3rd Dose
3rd Dose
1st Dose
1st Dose
1st Booster
Booster
Single Dose
2nd Dose
2nd Booster
2nd Booster
2nd Booster
DATE
RECEIVED
Cholera
Typhoid
Yellow Fever
Meningitis (HiB)
Varicella
Doctor’s Signature and Stamp_____________________________Date___/___/___
Villa No: 1522, Road No: 2733, Block No: 327, Adliya, Manama, Kingdom of Bahrain,
PO BOX 26355 Tel: 17715050, Fax: 17715048, www.kidzworldkindergarten.com
KIDZ WORLD
APPLICATION FORM
2015 - 2016
REGISTRATION AND SCHOOL FEES
Registration Fee: 70/- BD ( New Students Payment )
Resources Fee: 50/- BD ( Existing students per year )
Terms
Autumn
Sept-Dec
Spring
Jan-March
Summer
April-June
Payment Due
Year Groups
On or Before
15th, June 2015
Buzzing Bees
Pre Nursery
Nursery
Reception
Fees Per Term
BD
520/520/520/560/-
On or Before
31st, Dec 2015
Buzzing Bees
Pre Nursery
Nursery
Reception
390/390/390/420/-
On or Before
31st, March 2016
Buzzing Bees
Pre Nursery
Nursery
Reception
390/390/390/420/-
Please note that before the new term begins all fees & registration payments must be made.
NOTE:

Fees and Registration will not be refundable or transferable under any circumstances once
they have been paid.

Students will not be allowed to attend school if the fees and registration payments have not
been paid.

Students will be placed in the appropriate class based primarily on their Date of Birth.

Payment can be made by either cash or cheque in the name of KIDZ WORLD
KINDERGARTEN.
Parent or Legal Guardian Statement
I have read the above and agree to the terms at Kidz World Kindergarten for my child’s
name_____________________________
Name of Parent or Legal Guardian __________________________________________________________
Signature of Parent or Legal Guardian_________________ Date:
Villa No: 1522, Road No: 2733, Block No: 327, Adliya, Manama, Kingdom of Bahrain,
PO BOX 26355 Tel: 17715050, Fax: 17715048, www.kidzworldkindergarten.com
KIDZ WORLD
APPLICATION FORM
2015 - 2016
APPLICATION INFORMATION AND CHECK LIST
It is important that the application form is completed as most of the information is a
requirement of the Ministry of Education, it is also essential that the following information
and documentation is included with the application form.
A copy of your child’s passport
Two passport sized photographs
A copy of your child’s CPR
Vaccination Records
A copy of your child’s Birth Certificate
Non refundable Registration Fee BD 70/-
A copy of parent’s CPR
School fees paid by: EMPLOYER
EMPLOYER’S NAME
PARENTS
EMPLOYER & PARENTS
EMPLOYER’S ADDRESS
EPLOYER’S EMAIL ADDRESS
PARENT OR GUARDIAN SIGNATURE
I (we) the undersigned can confirm that I (we) have provided all the relevant information in
this application form and process, and it is accurate and true to the best of my (our)
knowledge at the time of completing the form.
OFFICE USE ONLY
RECEIPT NUMBER
INVOICE NUMBER
ACCEPTED FOR YEAR GROUP STUDENT ENTRY
DATE
STUDENT ID NUMBER
Villa No: 1522, Road No: 2733, Block No: 327, Adliya, Manama, Kingdom of Bahrain,
PO BOX 26355 Tel: 17715050, Fax: 17715048, www.kidzworldkindergarten.com