English Application Form - Disa Park Pre-Primary School

Name of previous school / playgroup attended

Half day (until 13:00)

Yes No

Aftercare (until 15:00)

Yes No

Aftercare (until 17:15)

Yes No

Number of children in family

Is child the 1st, 2nd, etc in family?

Names and ages of brothers and sisters

Allergies / Chronic problems (please specify if your child is allergic to a bee sting)

Any problems with hearing, sight, speech, nose, ears, teeth, urinating, nervous system, feet, legs

Name any operations your child has had, when they were, and what they were for

Select illnesses your child has been immunised for

Select illnesses your child has already suffered from

Alternative contact person (not mom/dad) in Cape Town

Full name and surname

Parent responsible for payment of school fees

Please send copies of the following with this entry form:

Please note: One term’s written notice is required should you wish to withdraw your child from Disa Park Pre-primary.

Acceptance

Upon submission, I confirm that all the information I have provided is accurate to the best of my knowledge. I also acknowledge that a one-term notice is necessary to withdraw from Disa Park Pre-Primary.