Online Admission Application | Crescent International School

1. Student Personal Details

First Name *

Middle Name

Last Name *

Preferred Name

Gender *

Date of Birth *

Place of Birth

Primary Nationality *

Secondary Nationality

Religion

Target Academic Year *

Target Year / Grade *

Preferred Starting Date

ID / Document Type *

ID / Passport Number *

Passport Issue Date

Passport Expiry Date

Passport Place of Issue

Preferred School Transport *

Home Address Details

House / Residence No. *

Soi / Road

Sub-District (Tambon) *

District (Amphoe) *

Province *

Postcode *

Country *

2. Educational Background & Language Ability

Previous Schools Attended

Language Proficiency

Is English the child's first language? *

Language Spoken in Family

English Skill Level Assessment

Skill	Very Good	Good	Fair	A little
Listening
Speaking
Reading
Writing

Other Language(s) Understood

Brother(s) / Sister(s) Attending CIS

General Background

Special Skills or Interests

Subjects Enjoyed / High Achievement

Placed Out of Normal Age Group?

Educational Psychologist / Special Needs Referral?

3. Medical History & Health Consents

Pre-existing Medical Conditions (e.g. Asthma, Diabetes, Nose Bleeds)

Regular Medication Taken

Specific Allergies & Treatments

Food Allergies & Treatment

Medication Allergies & Treatment

Skin Allergies & Treatment

Other Allergies & Treatment

Childhood Diseases / Medical Issues (Tick all that apply)

Previous Medical Operations or Relevant Info

Medical Records at Hospital in Bangkok (if any)

Permissions & Authorizations

Non-Prescription Medicine Permission: I give Crescent International School permission to administer non-prescription medicine (for fever, headache, stomachache) in accordance with manufacturer instructions.

Emergency Hospital Transfer Permission: In the event that my child needs emergency hospital care, I give Crescent International School permission to transport my child to hospital in my absence.

4. Parent & Guardian Information

Primary Contact (Parent / Guardian 1)

Title *

First Name *

Middle Name

Last Name *

Relationship to Student *

Nationality *

Visa Type

ID Type *

ID / Passport Number *

Mobile Phone *

Email Address *

Occupation / Employer

Job Title / Post

Office Contact Phone

Residential Address (if different from student)

5. Review Details & Complete Declaration

Enrollment Declaration & Terms Agreement

I hereby confirm my decision to enroll my child at CIS. I agree to obey and abide by the rules and regulations of CIS and guide my child in understanding and observing the school policies as stipulated in the Student Handbook. I also affirm that all the information provided in this application is true and accurate. I understand that withholding information or giving false statements on my part will make my child not eligible for admission.

I confirm that all information provided is accurate and agree to the school enrollment policies.