Admissions – KIBUBURA GIRLS SS

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KIBUBURA GIRLS’ SECONDARY SCHOOL

S1 Online Admission Application Form 2021

Dear Applicant, congratulations upon passing your Primary Leaving Examinations (PLE). As a measure to prevent and fight against COVID-19, application for S1 admission will be done online. Please fill and submit this form ONLY ONCE but remember to verify your information before submission. Should you encounter any problems/errors during the application process, please do not hesitate to contact us at: (+256)-787 016 016, (+256)-787 545 830 ,(+256)-775 576 601. Let us fight COVID-19 together. Keep observing all the SOPs!

Student's Information

The information supplied on this form will be regarded as confidential and shall be made available to the student’s teachers, administration staff and appropriate persons as deemed necessary by the School Administration.

Student NamesAll Names

GendaPick one!

FemaleMale

Date of Birth

Nationality

Address:

Village (LC1/Zone)

Sub County

Municipality

District

Country

PLE Performance

English

Social Studies

Mathematics

Basic Science & Health Educ.

Grade Aggregate

Parent/Guardian's Information

Parent/Guardian's Names

Phone Number

Emaila valid email

Relationship

Occupation

Parent/Guardian's Address

Sub county

Village (LC1/Zone)

Municipality

District

Country

Person to Contact in case of Emergency

Names

Emaila valid email

Relationship

Place of Work

Occupation

Person to Contact Address

Village (LC1/Zone)

Sub county

Municipality

District

Country

Health Information

The purpose of this section is to ensure that the school is aware of any medical conditions the student has that might be affected by, or, that might prevent him from engaging in any student activity including P.E. classes, athletic events, class studies and/or field trips. It is assumed by the school that, where necessary, the parents have sought the advice of the student’s physician prior to completing this form.

Student Blood Group required

Does the student have any health concerns or disabilities or diet restrictions or allergies (e.g. specific drugs, certain foods, insect stings, hay fever) of which the teacher or school nurse should be aware? (if Yes, please explain)

Explanation

0 /

My child has the following Chronic, Recurring Health Conditions (Please tick all that apply):

Does your child require emergency medication which may need to be administered in school such as Epi Pen, Asthma inhaler, allergy medication, etc.?

Comments

0 /

My child has the following disability (ies) that may affect his participation in typical school activities

pick one!

Visual impairment (E.g: Blindness/Low vision)Hearing impairment (E.g: Deafness)Autism (a developmental disability that impairs social interaction, verbal and non-verbal communication)Physical Disability (E.g: Spinal cord injury, cerebral palsy, amputation, cardiac conditions, paralysis, stroke, Etc.)Psychiatric DisabilitySpeech or Language impairment (E.g: stuttering, impaired articulation, or voice impairment)Others

Tell us more about yourself

What is your career interest

What is your favorite sport/game?

What are your hobbies/talents?

Student Statement

I have personally supplied (reviewed) the above information and confirm that it is true and complete to the best of my knowledge.

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