Online Application Form

Cambridge International School Admissions Form

* Indicates required field

Child's Name *

First

Last

Preferred Name (nickname) *

Date of Birth *

Gender *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Language Spoken at Home *

Child lives with (drop down to select) *

My child's doctor (name, address, telephone #) *

My child has the following allergies/health conditions *

1st Parent/Guardian Name *

First

Last

Preferred Email *

Phone Number *

Occupation *

Employer *

Work Phone Number *

Address (if different than child) *

Line 1

Line 2

City

State

Zip Code

Country

2nd Parent/Guardian Name *

First

Last

Preferred Email *

Phone Number *

Occupation *

Employer *

Work Phone Number *

Home Address (if different than child) *

Line 1

Line 2

City

State

Zip Code

Country

My child may be released to the following person/people (ID must match this information and email written to Director prior to release) *

Authorized Pickup - Name *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Mobile Telephone Number *

Relationship to Child *

Authorized Pickup - Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Mobile Telephone Number *

By signing below, I hereby certify that the information on this application is complete and correct.

Parent/Guardian (electronic signature) *

First

Last

Date of Electronic Signature *

Submit

General Information & School Requests
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