Application for Little Star Playschool 2019 | Little Star Playschool Claremont

Name of Child*

First Last

Applying for (which year)*

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Gender*

Male
Female

Date of Birth*

Home Language

Position of child amongst siblings

Do you currently have a child at Little Star

Yes
No

Current Playschool / Playgroup

Proposed school for Grade 1

Name of Father/Guardian*

First Last

Occupation*

ID Number*

Marital Status*

Married
Divorced
Separated
Unmarried

Cell number*

Work Number*

Email*

Name of Mother/Guardian*

First Last

ID Number*

Occupation*

Marital Status*

Married
Divorced
Separated
Unmarried

Cell number*

Work Number*

Email*

Emergency Contact Information

Name*

First Last

Relationship to child*

Work Number*

Mobile Number*

Family Doctor Name*

First Last

Doctor's Surgery*

Doctor Phone No.*

Medical Aid Details:

Medical Aid Scheme*

Medical Aid Number*

Required Documents

Upload the following Documents:

Child's Birth Certificate*

Accepted file types: pdf, png, jpg, Max. file size: 32 MB.

Child's Clinic Vaccination Card*

Accepted file types: pdf, png, jpg, Max. file size: 32 MB.

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Where did you hear about Little Star?*

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Emergency Contact Information

Required Documents

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