PRE REGISTRATION FORM 2021

Kindly fill up the form and we will reply on the Registration Process and Fee Structure via emails Insya ALLAH within 3 to 5 working days
We respect the confidentiality of the information given. It is solely for the usage of Tadika Lestari Impiana and the company Little Caliphs International Sdn Bhd. [Please contact us if you have NOT received any feedback within 7 working days]
STUDENT'S PARTICULAR
Student Full Name(according to Mykid)
Student Mykid No.
Student Gender	Female Male
Home Address
Student Date of Birth (dd/mm/yyyy)
Place of Birth
Student Age (on year of enrollment)	4 year 5 year 6 year
Nationality
Please select your option	Full day (7.30 am to 6.00 pm) Half day (7.30 am to 1.00 pm)
The student's total of siblings	1 2 3 4 5 More than 5
and the student is the	Eldest Second Third Fourth Fifth Youngest
Please specify if your child has asthma or allergy and state the severity from 1 to 10 (mild to severe)
Does your child has been immunized? [If YES, please submit a copy of his/her immunization record during FULL registration at school]	Yes No
Favourite food / drinks
Attended previous school? Please select the options	Kindergarten Taska / Playschool Taski No. Staying with nanny No. Staying at home
Please specify the name of the institution if you selected 'kindergarten'/'taska'/'taski'
PARENT'S / GUARDIAN'S PARTICULARS
Father's Name
Father's I/C No
Nationality
Race
Father's Occupation
Contact No.
Email Address
Workplace address
Mother's Name
Mother's I/C No
Nationality
Race
Mother's Occupation
Contact No:
Workplace address
Email Address
EMERGENCY CONTACT INFO (**other than parent / guardian)
Full name (Emergency Contact)
Contact No.
Relation to the student (e.g. grandparents, aunty, uncle), please specify
Name of siblings of TLI's ex-student or currently at TLI (if any)
Remark

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