ALEXANDRA HOUSE SCHOOL
                                      King George V Avenue,
                                                       Floreal,  Mauritius.

Tel / Fax : (230) 696 4108     E-mail: admin@alexandrahouseschool.com


Application for Admission

Surname of Child:___________________________________________________________________

First name/s: _______________________________________________________________________

Date of Birth: ______/_______/_______ Place of Birth: _____________________________________

Nationality: _______________________ Religion:__________________________________________

Present Contact Address: _____________________________________________________________

                                    ______________________________________________________________

Contact Tel. No: _______________ E-mail: ________________________________ Fax: __________

Full Name of Father/Guardian & Title (Mr. Dr.):         Full name of Mother/Guardian & Title (Mrs./ Dr):
(if guardian, please state relationship)                                            (if guardian, please state relationship)

___________________________________              ________________________________________

Nationality:                                                           Nationality:

___________________________________              ________________________________________

Occupation:                                                          Occupation:

___________________________________              ________________________________________

Name and Address of Employer:                             Name and Address of Employer:

___________________________________              ________________________________________

___________________________________              ________________________________________

___________________________________              ________________________________________

Employer’s Tel. No: ___________________             Employer’s Tel. No: _______________________

 

 

Please list all previous schools attended by your child, including dates and class:

Name of School and Country

Attended From - To

Class

   
     
     
     


Expected length of stay in Mauritius: ____________________________________________________

Child’s hobbies/interests: _____________________________________________________________

Child’s first language: ________________________________________________________________

Language spoken by: Mother: ________________________  Father: __________________________

                               Brothers/sisters:  ___________________________________________________

Other languages spoken by the child:   ___________________________________________________

Please describe your child’s current level of English: (please tick as appropriate)

                o new to English                                o familiar with English

                o a confident user of English               o a fluent user of English

Where do you plan to send your child for secondary schooling (Please indicate name of school 
and/or country, if known.) ____________________________________________________________

Has any aspect of your child’s development ever given cause for concern? If yes, please specify:

__________________________________________________________________________________

__________________________________________________________________________________

Has your child received extra support in a previous school ?  _____________

Has your child ever received: (Please circle the correct response)

        Psychological assessment? Yes / No                     Occupational therapy? Yes / No

        Physiotherapy? Yes / No                                      Speech and language therapy? Yes / No

 

THE FOLLOWING SHOULD BE INCLUDED WITH THIS APPLICATION:

a copy of your child’s birth certificate.

recent school reports (where applicable).

a registration fee of 1000 rupees.



Signature of Parent or Guardian: _______________________________ Date: ___________________

Administrative Use only

Date of expected entry: ___________ Age at expected entry: ______ Class placement: ___________