USIHS Admission Form

Admission Form

Section A: Child's Bio Data

First Name:

Other Name:

Surname:

Prefered Name:

Gender

Address:

Does the child has any form of disability?

If Yes, please specify the type of disability:

Child's Date of Birth

Class Applying For

Academic Session

Section B: Parents/Guardian Information

Parent's Full Name

Phone Number

Nationality

Country

State/Province

State

LGA

Parent's Gender

Parent's Employment Status

Email Address

Residential Address

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Consent

I have read and agreed with the USIHS policy and i solemnly declared that the above provided information are correct to the best of my knowledge

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