Children are gifts from GOD (Psalm 127:3) and parents play an important role in their lives. Parents have to make important decisions in training child

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Child Name:
Parent Name:
Email:
Mobile No:
Child Age:
Status/Pass:
Enquiry:
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Children are gifts from GOD (Psalm 127:3) and parents play an important role in their lives. Parents have to make important decisions in training child

Contact us for a no-obligation consultation!

Child Name:
Parent Name:
Email:
Mobile No:
Child Age:
Status/Pass:
Enquiry:
Code:

Input Code here:
 

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IMPORTANT

1) Please complete the form in full.
2) Applications with incomplete information and/or not accompanied with supporting documents will not be considered.
3) Where not applicable, please indicate “N/A” in the blanks.
4) Registration Fee: Payment of Registration Fee is to be made payable to “Heritage Academy” and must be sent with applicant completed application form attached with the certified true copies of applicant certificates and transcripts. This fee is non-refundable.


Full Name in BLOCK LETTER
Alias (If any)
NRIC Number (if applicable)
Race
Nationality
Type of Pass:
FIN (if applicable)
Validity of Pass
Date of Birth (DD/MM/YYYY):
Gender
City / State
Country of Birth
School Last Attended
Last Grade Completed
Home Tel. No (if any)
Passport Number
Issue Date of Passport
Expiry Date of Passport
Country of Issue of Passport
Place of Issue of Travel Document
Residential Address in Singapore
Address in Home Country (if any)
Has applicant resided in any country for one year or more during the last 5 years?
Yes
No
List the countries in which applicant have resided for one year or more during the last five years:
Country
Address
Period of Stay (MM/YYYY)
-
-
-

FATHER’S / GUARDIAN’S INFORMATION

Father’s / Guardian’s Name
Date of Birth (DD/MM/YYYY):
Type of Pass:
NRIC / FIN No
Validity of Pass
Nationality
Passport Number
Expiry Date of Passport
Occupation
Company Name
Mobile Number
Email Address

MOTHER’S / GUARDIAN’S INFORMATION

Mother’s / Guardian’s Name
Date of Birth (DD/MM/YYYY):
Type of Pass:
NRIC / FIN No
Validity of Pass
Nationality
Passport Number
Expiry Date of Passport
Occupation
Company Name
Mobile Number
Email Address

SIBLING INFORMATION

I do not have any information to declare for the below.
Full Name
Relationship
Date of Birth (DD/MM/YYYY)
Nationality
Residential Status in Singapore

RELIGIOUS BACKGROUND

Church Attending
Address
Pastor
Father Christian?
Yes
No
Mother Christian?
Yes
No
Has applicant ever made a profession of faith in Christ?
Yes
No

MEDICAL INFORMATION

Family Physician (if any)
Phone Number
Does student have any physical defects or allergies?
Yes
No
If yes, please explain:
Has student received the following immunizations?
DTP / DTaP / DT / Td
Yes
No

If yes, please indicate which:
Polio
Yes
No
Varicella
Yes
No
MMR
Yes
No
Hepatitis B
Yes
No

SCHOLASTIC INFORMATION

Has student ever been expelled, dismissed suspended, or refused admission to another school?
Yes
No
If yes, please explain:
Has student ever had disciplinary difficulty at school?
Yes
No
If yes, please explain:
Has student have a juvenile or arrest recordl?
Yes
No
If yes, please explain:
Please indicate academic level of student’s previous work
Has student ever failed an academic subject in school?
Yes
No
If yes, please explain:

EMERGENCY CONTACT IN SINGAPORE

Name
Relationship to Applicant
Contact Number

EMERGENCY CONTACT IN HOME COUNTRY (FOR FOREIGNERS ONLY)

Name
Relationship to Applicant
Contact Number

GENERAL INFORMATION

How did you hear about this school?
Reason(s) for selecting this school

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