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New Student Registration

HomeStudent Enrollment CenterNew Student Registration

Atikali Learning Lab

New Student Registration

Welcome to Atikali Learning Lab, where curiosity ignites, and potential takes flight! We are excited to have your child as part of our learning community.

- Step 1 of 6

Student Information

Name: *

First

Middle

Last

Date of Birth: *

Gender: *

Country of Birth: *

In which country was the child born?

Country of Citizenship: *

What is the child's nationality?

Home Address: *

Address Line 1

City

State / Province / Region

Postal Code

Country

Is your mail address the same as your home address: *

Mailing Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Emergency Contact

Name of Emergency Contact: *

First

Last

Relationship to child: *

Email: *

Phone: *

Occupation:

Child's Health Information

• Known allergies:

Medical conditions:

Current medications (if any):

Parent/Guardian 1 Information

Parent/Guardian Name: *

First

Last

Relationship to Child: *

Email *

Phone *

Occupation:

Place of Employment:

Add a second Parent/Guardian? *

Parent/Guardian 2 (if applicable):

Name *

First

Last

Relationship to Child: *

Email *

Phone *

Occupation:

Place of Employment:

Enrollment Details

Please complete all applicable fields in this section.

Atikali Programme: *

Programme Session: *

Days of Attendance: *

Tuesday
Wednesday
Thursday
Friday

Please select a minimum of two (2) days. A parent/primary care giver must accompany the child during all sessions.

Preferred Start Date: *

Extended Care (3:30pm- 6:00pm): *

Additional charges will be applied for this service

Days for extended care:

Monday
Tuesday
Wednesday
Thursday
Friday

Additional Information

Please share if your child has any special interests?

Does your child have any previous school experience? *

How did you hear about us?

Referral
Social media
Mass media (radio/ tv)
Internet Ads
Print Ads
Other

Other - How did you hear about us?

Acknowledgment:

I, the undersigned, understand that the information provided in this form is accurate, true, and complete. I agree to abide by the rules and policies of Atikali Learning Lab Inc.

Parent/Guardian *

First

Last

List of Required documents:

1. Child’s birth certificate
2. Child’s Immunization Records (up to date)
3. Parent/Guardian identification (National ID card, Passport, Driver’s License)
4. Previous school records (if applicable)
5. Special education documents (if applicable)
6. Custody documents i.e., legal documentation proving custody arrangements, if the child's parents are divorced or separated (if applicable)
7. Notarized Guardianship Affidavit (if applicable)

Message

Curiosity blooms potential.

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