ADMISSION | High Horizons Learning center

STUDENT INFORMATION

Last Name:

First Name:

Nickname:

Birthday:

Age:

Gender:

Address:

FAMILY PARTICULARS (UPDATES)

*If one or both of the parents are missing or not in communication with the child, put N/A beside the name.

Name of Child's Father:

Father's Age:

Father's Email:

Father's Contact No:

Father's Occupation:

Father's Company Name:

Name of Child's Mother:

Mother's Age:

Mother's Email:

Mother's Contact No:

Mother's Occupation:

Mother's Company Name:

Still together

No longer together

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