KG, NURSERY AND PRIMARY SCHOOL ADMISSION FORM
Surname
First Name
Other Name
Exam Number
Session
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2020/2021
2021/2022
2022/2023
Term
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1st Term
2nd Term
3rd Term
Proposed Class
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KG 1
Nursery 1
Nursery 2
Nursery 3
Primary 1
Primary 2
Primary 3
Primary 4
Primary 5
Entry Mode
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Day
Boarding
Date of Birth
Gender
Male
Female
Religion
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Christianity
Islam
Others
Denomination
Genotype
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AA
AS
AC
CC
SC
SS
Blood Group
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A+
A-
B+
B-
AB
O+
O-
Nationality
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Nigerian
Non Nigerian
State of Origin
L.G.A
Home Town
Language(s) Spoken
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English
Afar
Abkhazian
Afrikaans
Amharic
Arabic
Assamese
Aymara
Azerbaijani
Bashkir
Belarusian
Bulgarian
Bihari
Bislama
Bengali/Bangla
Tibetan
Breton
Catalan
Corsican
Czech
Welsh
Danish
German
Bhutani
Greek
Esperanto
Spanish
Estonian
Basque
Persian
Finnish
Fiji
Faeroese
French
Frisian
Irish
Scots/Gaelic
Galician
Guarani
Gujarati
Hausa
Hindi
Croatian
Hungarian
Armenian
Interlingua
Interlingue
Inupiak
Indonesian
Icelandic
Italian
Hebrew
Japanese
Yiddish
Javanese
Georgian
Kazakh
Greenlandic
Cambodian
Kannada
Korean
Kashmiri
Kurdish
Kirghiz
Latin
Lingala
Laothian
Lithuanian
Latvian/Lettish
Malagasy
Maori
Macedonian
Malayalam
Mongolian
Moldavian
Marathi
Malay
Maltese
Burmese
Nauru
Nepali
Dutch
Norwegian
Occitan
(Afan)/Oromoor/Oriya
Punjabi
Polish
Pashto/Pushto
Portuguese
Quechua
Rhaeto-Romance
Kirundi
Romanian
Russian
Kinyarwanda
Sanskrit
Sindhi
Sangro
Serbo-Croatian
Singhalese
Slovak
Slovenian
Samoan
Shona
Somali
Albanian
Serbian
Siswati
Sesotho
Sundanese
Swedish
Swahili
Tamil
Telugu
Tajik
Thai
Tigrinya
Turkmen
Tagalog
Setswana
Tonga
Turkish
Tsonga
Tatar
Twi
Ukrainian
Urdu
Uzbek
Vietnamese
Volapuk
Wolof
Xhosa
Yoruba
Chinese
Zulu
Igbo
Recent School(s) attended with dates.
Current Class
Select Class
KG 1
Nursery 1
Nursery 2
Nursery 3
Primary 1
Primary 2
Primary 3
Primary 4
Primary 5
Expected duration of stay in Deril Academy
Medical History
Name and address of child's medical practitioner.
Parent/Guardian Surname
Parent/Guardian Other Names.
Relationship to Child
Occupation
Postal Address (in Nigeria)
Home Address
Phone Number
Payment Option
Choose payment option
Online Payment
Bank Transfer
Amount