Prospective Student Initial Inquiry Form
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Student's family/ surname: |
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Student's
given name: |
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Student's middle name: |
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Gender: |
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Country of present residence: |
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Country or countries of citizenship: |
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Contact (daytime) telephone number with country code: |
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Fax number, with country code: |
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E-mail address: |
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Type e-mail again: |
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Date of birth: |
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Month
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Year
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| Anticipated date of entry to Saint Maur |
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Year
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| Current Mailing Address: Full address with zip code |
Street address: |
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City: |
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State/Province: |
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Country/Region: |
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Zip /Postal code: |
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Education of child:
(Schools attended, past and present) |
Current school name, city and country: |
(e.g. Saint Maur, Yokohama, Japan) |
Current grade (if U.S. system): |
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Current "Year/Form" etc for U.K. system or other System |
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Years attended: |
(calendar years e.g. 2001- 2002) |
| Schools attended in the past |
Previous school name, city and country: |
(e.g. Saint Maur, Yokohama, Japan) |
Years attended: |
(calendar years e.g. 2001- 2002) |
Grades attended
(if U.S. system):
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(e.g. 1-2) |
Year/Form attended
for U.K. or other system: |
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Previous school name, city and country: |
(e.g. Saint Maur, Yokohama, Japan) |
Years attended: |
(calendar years e.g. 2001- 2002) |
Grades attended
(if U.S. system): |
(e.g. 1-2) |
Years/Form attended
for U.K. or other system: |
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Does your child have special needs (Yes/ No): |
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If yes, explain needs and services required
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| Parents' information:
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Father's country of citizenship: |
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Mother's country of citizenship: |
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Resident of Japan |
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Additional information:
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