O' Level Application Form - St. Mark's SSS Naminya

O' LEVEL APPLICATION FORM (Senior 1-4)

Academic Year: _________________

First Name *

Middle Name

Last Name *

Date of Birth *

Gender *

Religion

Denomination

Passport
Photo
(Attach Here)

CONTACT INFORMATION

Guardian/Parent Name *

Relationship to Student *

Guardian Phone Number *

Guardian Email

Physical Address

EDUCATIONAL BACKGROUND

Primary School Attended *

PLE Index Number *

PLE Year *

PLE Aggregate *

Subjects Passed (List all)

PROGRAM SELECTION

Entry Class *

Day Scholar / Boarding *

DECLARATION

I hereby declare that the information provided in this form is true and accurate. I understand that any false information may lead to cancellation of admission. I agree to abide by the school's rules and regulations.

Parent/Guardian Signature: _________________________

Date: _________________

FOR OFFICE USE ONLY

Date Received:

Application No.:

Interview Score: