International School Kuala Lumpur

ADMISSIONS APPLICATION

1 Student Information

Student’s Name: (Family Name/Frist Name/ Middle Name)
Preferred name for student directory:
Expected date of enrollment:
Gender:	Male Female
Date of Birth (MM/DD/YYYY):
Place of birth :(City / Country)
Country of citizenship:
*Address:
*Country of citizenship:
*Passport number :
*Language spoken at home:
Country Issuing Passport:
Other language(s) spoken:
Home address of Parent/Guardian:


Home Phone:
Home Fax:
*E-mail:
I agree to have my name, address and phonenumber published in the student directory:	Yes No

2 Family Information

Father	Mother

Country of citizenship:

Will the parents be residing with the student?	Yes No
If No, please provide name of local guardian?
Does the student complete Homework?
Other comments to assist the teacher?
(The guardian must reside in the same residence as the student. As the guardian, you are required to work in partnership with the school (monitor the student’s attendance and inform the school if the student is absent, meet with teachers and counselors when required, etc.) You are responsible to notify the Admissions Office should the guardianship arrangement be changed or terminated. If the guardianship policy is not met, the student(s) may be asked to leave school.)
Name of other siblings applying to / currently in ISKL:	Grade

3 Mailing and Billing Information

Mailing address for school correspondence:
Father
Home address Office address
Mother
Home address Office address
Billing address:
Father
Home address Office address
Mother
Home address Office address
If billing should be sent to another address, please provide mailing information:

4 Company Information

Parent’s / Guardian’s Name:
Father	Mother

Position:
Father	Mother

Company name:
Father	Mother

Company address:
Father	Mother



Work Phone # 1:
Father	Mother

Work Phone # 2:
Father	Mother

Fax:
Father	Mother

Hand Phone:
Father	Mother

Is company a U.S. affiliate?
Father	Mother
U.S Government
Yes No	Yes No
U.S. Department of Defense
Yes No	Yes No
Contracted to a U.S. Government agency
Yes No	Yes No
Private Company
Yes No	Yes No
U.S. company name and address:
Father	Mother



Does the company above pay full tuition fees:	Yes No
What percentage of fees does company pay?

5 Emergency Information

Person to be contacted in an emergency if parents are \| not available. Please use a person outside your household.
Contact number1:	Contact number2:
Name:	Name:

Address:	Address:



Telephone and H/P:	Telephone and H/P:

Language preferred / spoken:	Language preferred / spoken:

6 Student's Educational Information

Name of School City/Country (Please begin with the most recent year)
Type ofCurriculum (American/British, etc.)
Attended From / To (mo / yr)
Age
Grade/Standard/Form/Yr
Language of Instruction

Telephone and H/P:	Telephone and H/P:

Language preferred / spoken:	Language preferred / spoken:

7 Student's Detailed Information

1	Has the student previously submitted an application or attended ISKL?	No Yes
2	Has the student received any special academic, social, emotional support (i.e. speech, learning disability, counseling, etc.) and/or psycho- NO YES educational testing?	No Yes
	2a. If yes, what type of support has the student received? (Please attach relevant reports and test results.)	No Yes
3	Has the student ever repeated a grade level?	No Yes
4	Has the student ever skipped a grade (double promotion)?	No Yes
5	Has the student ever been asked to leave a school?	No Yes
6	Does the student adjust to new situations easily?	No Yes
7	Has the student ever been in an English-as-a-second-language program?	No Yes
8	Does the student read for pleasure?
9	Does the student complete Homework?
10	Does the student show independence?
11	Other comments to assist the teacher?

Other Information

Questions / Comments:

* indicates a required field.

Head Of Admissions
P.O. Box 12645
50784 Kuala Lumpur

(603) 4259 5600
(603) 4259 5626 (D.L.)
(603) 4257 9044 (Fax)

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