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Enrolment Form
Enrolled Class:    Date of Commencement:
Full-day Program 3 Days a week Billed Per Term   
Morning Program 4 Days a week Billed Per Year    
  5 Days a week  
YOUR CHILD'S INFORMATION
Child's Last Name: First Name:
Date of Birth: Gender:      Male    Female
Nationality: Religion:
Languages spoken/understood:
Previous Education:
BILLING & CONTACT INFORMATION
Preferred Contact (Billing)
Father    Mother    Guardian
 
Second Contact
Father    Mother    Guardian
Name:
Nationality:
Address:
Home Phone:
Mobile Phone:
Email:
First Language:
Other Languages:
Religion:
Occupation:
Company Name:
Company Phone:
Company Email:
Preferred Method of Contact:    Phone    Email    Notes sent with Child
Is a Red Invoice required in the company's name:    Yes    No
If Yes, please provide us with: Tax Code: ,Company address What are the names and birthdates of other children in your family? Do you have any special skills you could contribute to our Kindergarten's program or have time to volunteer – eg read a story in your native language, play an instrument?
MEDICAL INFORMATION
Specify any medical conditions your child has which requires monitoring or medication: Specify any allergies your child has: Relevant medical history: Details of your doctor in Hanoi:

Immunisation Record:
Polio Series Date
Diptheria Tetanus Pertussis Series Date
MMR Series Date
Hepatitis A Series Date
Hepatitis B Series Date
Typhoid Series Date
HIB (Haemophilus Influenza Type B) Series Date
Japanese Encephalitis Virus Series Date
Rabies Series Date
EMERGENCY CONTACT DETAILS
Emergency Contacts – please provide two other than parents:
Contact 1   Contact 2
Name:
Home Phone:
Mobile Phone:
Relationship:
GENERAL INFORMATION
Does your child have any special dietary needs? If yes, please specify
Is your child toilet trained?
Does your child have any special comforter? If yes, please specify
Does your child have any special interests? If yes, please specify
Does your child have any fears? If yes, please specify
Does your child usually sleep during the day? If yes, for how long?
COLLECTION AUTHORISATION
In addition to the parents/guardians listed above, please provide details of those persons authorised to collect your child from school.
Authorisation 1 Authorisation 2 Authorisation 3
Name
Mobile Phone
Home Phone
Relation to child
Photo (3x4cm) (optional)
ATTENDANCE INFORMATION
Date All Day Program Morning Program Afternoon Program After School Program
Monday
Tuesday
Wednesday
Thursday
Friday
BUS SERVICE
Will your child use the bus service provided by our Kindergarten?
If Yes:
What is the pick up address?
What is the drop off address?

What days will you require the bus?
Monday Tuesday Wednesday Thursday Friday
Pick Up for Morning Session
Drop off after Morning Session
Pick Up for Afternoon Session
Drop off after Afternoon Session
Pick up for After School Activities
Drop off after After School Activities
ADDITIONAL INFORMATION
PERMISSION & AGREEMENT
I give the management and staff at Hanoi International Kindergarten the authority:
YES
- To use the name and/or photo of my child for the Kindergarten displays and/or promotional use
- To transport my child to and from school or kindergarten on the bus
- To apply sunscreen to my child for outside play
- For Kindergarten personnel and students to observe my child to assist in developing programs
- To allow the people listed as Parents & Contact Persons to drop off and collect my child from the Kindergarten unless otherwise specified
- To allow the people listed as Parents & Contact Persons to sign off Medication Records and Accident/Incident Reports, unless otherwise specified
- To allow the staff to administer basic first aid if required, eg bandaids on scratches, ice on bumps
- To provide my contact details as part of a Class Contact List to be provided to other class members
I agree to:  
- Make timely payments of fees due
- Notify the Kindergarten if my child will not be attending
- Notify the Kindergarten if someone other than the authorised persons will collect my child
- Ensure that my child does not bring any dangerous toys or equipment to the Kindergarten
- Follow the policies of Hanoi International Kindergarten
Parent/Guardian Signature
Parent/Guardian Name
Date
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Visited: 4080079