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On-Line Application

Before continuing, please read the Application Procedures.

* denotes a required field.

*Mode of Payment:

The amount payable through E-nets (Visa/Master) is $1145.75 which includes an additional administration fee of 3.5%

A. Commencement & Grade Level

*Proposed Commencement Date: Day Month Year
*Grade:
Early Childhood Education: Morning Programme
Afternoon Programme

B. Student Information

*Family/Last Name:
*First Name:
Middle Name(s):
*Common Name (if different):
*Date of Birth: Month: Year:
*Sex: Male Female
*Country of Birth:
*Nationality:
*Dependent pass: Yes No
*Student Pass: Yes No
*Singapore Permanent Resident (PR):    Yes No
*Dual Citizenship: Yes No
If Yes, state countries:
*1st Language:  
2nd Language:
English Proficiency(For Non-English speaker only): High      Medium  Low

C. Sibling Information

*Siblings currently attending CIS: Yes  No  
Slibling #1 Name:
Slibling #1 Grade:
Slibling #2 Name:
Slibling #2 Grade:

*Siblings applying to attending CIS:  
Slibling #1 Name:
Slibling #1 Grade:
Slibling #2 Name:
Slibling #2 Grade:

D. Correspondence

*Student will be residing with: Parent    Guardian
*Name of correspondence:
Residence Address in Singapore:
Postal Code (Singapore):
Tel: (Home)
Fax (Home):
Mobile:
*Email:

E. Billing Information (if different from above)

Company/Department:
Billing Address for Tuition Fees :
Attention to:

F. Emergency Contact Information

Contact Name:
Relationship to student:
Emergency Home Phone:
Emergency Office Phone:
Emergency Hand Phone:

G. Father's Information

*Father's Name:
Father's Current Address:
Father's Home Phone:
Father's Home Fax:
Father's Mobile
*Father's Email:
Father's Occupation:
Father's Company:
Father's Office Phone:
Father's Office Fax:

H. Mother's Information

*Mother's Name:
Mother's Current Address:
Mother's Home Phone:
Mother's Home Fax:
Mother's Mobile
*Mother's Email:
Mother's Occupation:
Mother's Company
Mother's Office Phone
Mother's Office Fax 

I. Previous Educational Institutions Attended (last two schools)

*School Name:

(Enter "n/a" if not applicable)

*Language of Instruction:

(Enter "n/a" if not applicable)

*Date of Attendance:

(Enter "n/a" if not applicable)

*Highest Level Completed:

(Enter "n/a" if not applicable)

J. Additional Information.

*Health - Does your child/ward have any health problem, which may have an influence on his/her participation in the classroom or at sports? For example, does your child have any allergies? Please submit all medical reports pertaining to any health problem(s).

*Academics - Has your child/ward ever had (please submit all pertaining documents)

*Enrichment or remedial help: Yes  No
*A learning difficulty:  Yes  No
*Psychological assessment/treatment: Yes  No
*A behavioural difficulty:   Yes  No
*Other (if yes, please specify below): Yes No

Other Academic Concerns - Specify.

*Field Trips - The school programme includes field trips or activities which will involve traveling to different venues in Singapore. Do you wish your child to participate? Comments are welcome.

*Other Information - Any other comments or information, which will enable the teachers to understand your child better?

By selecting this checkbox, I certify that I have read, understood and agree to the Terms and Conditions for Enrollment. I certify that all the information contained within this application are true.


To enable the "Submit" button, you must select the above checkbox
to confirm your acceptance of the terms and conditions.
 

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Last Modified: March 5, 2009

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