ISK APPLICATION FOR ENROLLMENT

Applicant Information

Firstrequired

Middle

Lastrequired

Suffix

Preferred Name

Street Addressrequired

Address 2

Address 3

Cityrequired

Staterequired

Region

Ziprequired

Countryrequired

Gender*

Female Male Prefer not to say

Student Citizenshiprequired

Date of Birthrequired (dd/mm/yyyy)

Student Birth Cityrequired

Student Birth Staterequired

Student Birth Countryrequired

Intended Start Date at ISKrequired (mm/dd/yyyy)

Grade Level that the Student is Applying For:required

Student's Primary Languagerequired

Additional Languages

How did you learn about ISK?

ADDITIONAL APPLICANT INFORMATION

Has the student ever received, or do they currently receive, additional support such as learning support, counseling, speech therapy, physical therapy, or occupational therapy?*

Yes No

If your answer to the previous question was 'yes', please complete the Student Support Questionnaire.

Has the applicant ever repeated or advanced any grade(s)?*

Yes No

If yes, please explain:

PARENT/GUARDIAN 1 INFORMATION

Prefix

Firstrequired

Middle

Lastrequired

Suffix

Relationship to Applicantrequired

Street Addressrequired

Address 2

Address 3

Cityrequired

State

Region

Zip

Countryrequired

Cell Numberrequired

If this is an international number, please include the country code.

Home Number

Work Number

Ext

Email Addressrequired

Employerrequired

Employer City and Countryrequired

Custodial Rights for the Applicant?*

Yes No

Financial Responsibility for the Applicant?*

Yes No

PARENT/GUARDIAN 2 INFORMATION

Prefix

Firstrequired

Middle

Lastrequired

Suffix

Relationship to Applicantrequired

Street Addressrequired

Address 2

Address 3

Cityrequired

State

Region

Zip

Countryrequired

Cell Numberrequired

If this is an international number, please include the country code.

Home Number

Work Number

Ext

Email Addressrequired

Employerrequired

Employer City and Countryrequired

Custodial Rights for the Applicant?*

Yes No

Financial Responsibility for the Applicant?*

Yes No

Emergency Contact Information

Prefix

Firstrequired

Middle

Lastrequired

Suffix

Relationship to Applicantrequired

Street Addressrequired

Address 2

Address 3

Cityrequired

State

Region

Zip

Countryrequired

Cell Numberrequired

If this is an international number, please include the country code.

Home Number

Work Number

Ext

Email Addressrequired

Custodial Rights for the Applicant?*

Yes No

Applicant's Previous Schools

School Name

School Phone Number

School City

School Country

Date Started (dd/mm/yyyy)

Date Left (dd/mm/yyyy)

Primary Language of Instruction

Additional Language(s) Studied

School Name

School Phone Number

School City

School Country

Date Started (dd/mm/yyyy)

Date Left (dd/mm/yyyy)

Primary Language of Instruction

Additional Language(s) Studied

School Name

School Phone Number

School City

School Country

Date Started (dd/mm/yyyy)

Date Left (dd/mm/yyyy)

Primary Language of Instruction

Additional Language(s) Studied

REFERENCES

For applicants grade K-5, please list 1 reference from the applicant’s current classroom teacher.

For applicants grade 6-12, please list 1 English Language Arts teacher reference, 1 math teacher reference, and 1 counselor or administrator reference from their current school.

Name

Teacher Counselor Principal/Administrator

Reference's School Email Address

Name

Teacher Counselor Principal/Administrator

Reference's School Email Address

Name

Teacher Counselor Principal/Administrator

Reference's School Email Address

In addition to this application, you must also submit during the application process:

⃞ A copy of the information/photo page of the applicant’s passport

⃞ Copies of the applicant’s two most recent report cards

⃞ A completed copy of the grade-appropriate ISK language survey

⃞ If applicable, a completed copy of the ISK Student Support Questionnaire

⃞ If applicable, a completed copy of the ISK Student Language Questionnaire

Please note that as part of the admissions process, you may be contacted regarding placement testing in the areas of reading, mathematics, world language and writing.

Upon admission to ISK, you must submit:

⃞ A copy of the applicant’s vaccination records

⃞ A completed copy of the ISK Health Form

Electronic Signatures

The electronic signatures below and their related fields are treated by the International School of Kigali like a physical handwritten signature.

Parental Agreement

Students may not enroll at ISK unless at least one parent or legal guardian is a full-time resident of Rwanda. I, the undersigned, agree that this applicant will be living with at least one parent or a legal guardian while enrolled at ISK. I hereby give ISK permission to obtain records from the applicant’s current and previous school(s).

I hereby certify that the information given in this application is true and complete to the best of my knowledge. I fully understand that if I fail to provide accurate information for this application, ISK reserves the right to restrict entry into or withdraw from the school.

I understand that data collected will be used for processing the admission application only.

First and Last Name

Date Picker (dd/mm/yyyy)

Release of Records

I waive my right to access confidential information contained in my child’s admission file.

First and Last Name

Date Picker (dd/mm/yyyy)

Electronic Signature

My signature below affirms that all of the information contained in this application is correct, complete, and honestly presented. I understand that withholding or misrepresenting information in this application may jeopardize my child’s admission.

First and Last Name

Date Picker (dd/mm/yyyy)