Admission Form | Busy Brain Achievers' Academy

Student's Passport

Complete this form in block letters. Details with * MUST be filled.

STUDENT'S DETAILS

Passport Preview

Student's Passport *Recent passport photograph, maximum 2MB.

Name *

Sex *

Date of Birth *

Age

Town of Origin

LGA

State of Origin

Nationality

Religion

PREVIOUS ACADEMIC RECORD

Name of School

Class *

Year

Last Session's Average

Present Class *

Student's Address

Residential Address

PARENT'S DETAILS

Name *

Occupation

Phone No. *

Email Address

SECURITY DETAILS

Who Will Pick the Student after Dismissal?

1st Person

2nd Person

3rd Person

STUDENT'S HEALTH STATUS

Student's Special Health Challenge

Disability

Allergies

Genotype

Referral ID

STUDENT'S DECLARATION

By appending signatures below, you hereby declare that the information provided above is correct, and you give consent that the information should be used to process your admission. If found false, you stand the risk of losing your admission in good faith. You've also read and understood the laid down rules and regulations governing this school, and pledge to abide by them. You also agree to bear any appropriate disciplinary action(s) meted against your misconduct.

Read Policy here: busybrainaca.com.ng/policy

I agree to the declaration above. *

Student's Signature

Parent's Signature *