SECONDARY SCHOOL ADMISSION FORM

Surname

First Name

Other Name

Exam Number

Session

Term

Proposed Class

Entry Mode

Date of Birth

Gender

Male

Female

Religion

Denomination

Genotype

Blood Group

Nationality

State of Origin

L.G.A

Home Town

Language(s) Spoken Press CTRL+click to add new entries.

Recent School(s) attended with dates.

Current Class

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

Amount