New Learner Registration – King Makers Academy

Surname First name Date of Birth Gender Nationality State of Origin

Address Applying Class

Blood Group Genotype Medical Conditions/Allergies

Previous School Reason for leaving Areas of interest/needs

Full name Relationship Phone Email Address

Emergency contact name Emergency contact phone Authorized pickup persons

Passport Photo

Optional supporting documents (upload now or bring to school later)

Birth Certificate Last Class Report (optional) Medical Certificate (optional)

Draw with mouse or upload an image. Drawing takes precedence if used.

Or upload signature image:

Register as New Learner