Parent/Guardian Information
Student Information
Medical & Special Needs
Additional Details
Full Name *
Email Address *
Phone Number *
Alternative Phone Number
Preferred Contact Method *Preferred Contact MethodPhoneEmailWhatsApp
Relationship to Student *Relationship to StudentMotherFatherGuardian
Home Address
Occupation & Employer
Emergency Contact Name & Number
Terms & Conditions AgreementI confirm that the information provided is accurate
I allow my child’s photos to be used in school mediaYesNo
Child’s Full Name
Child’s Date of Birth
Current School (if applicable)
Nationality
GenderGenderMaleFemale
Academic Year of EnrollmentAcademic Year of Enrollment2025202620272028202920302031
Grade Level Interested InGrade Level Interested InGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8
Languages Spoken at Home
Preferred Clubs or Activities at LongridgeSportsMusicDramaMusicSTEM
Dietary Preferences or RestrictionsVegetarianNon-VegetarianAllergies
Does the student participate in extracurricular activities?No/YesNoYes
Will the student require school transport? No/YesNoYes
Upload Passport-Sized Photo* Images only
Previous School Records (if applicable images or PDF)
Does the student have any medical conditions?No/YesNoYes
Does the student have any allergies? No/YesNoYes
Does the student have any special learning needs?No/YesNoYes
Primary Doctor’s Name & Contact Information
Health Insurance Provider (if applicable)
Do you have a child currently Enrolled at Longridge?No/YesNoYes
Does the student have any siblings?No/YesNoYes
Has your child ever had any disciplinary issues? No/YesNoYes
What interests you about Brookhurst International School?