DECLARATION FOR SCHOOL ADMISSION MIDDLE SCHOOL PROGRAMME (Grades G6 G10)

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DECLARATION FOR SCHOOL ADMISSION MIDDLE SCHOOL PROGRAMME (Grades G6 G10) STUDENT INFORMATION Student s full name Male Female. Given Middle Surname/Last name Birth date Place of birth (Town, Country) - -.... (DD) (MM) (YY) Nationality (list all if more than one) Preferred start date at ISoP. PESEL/Passport No... Anticipated duration of stay at ISoP Current grade. Expected grade of enrolment STUDENT S SCHOOL BACKGROUND List the history of all schools attended (most recent first): 2. 3. STUDENT RECORD REQUEST The student above is applying for admission to the International School of Poznan. In order to be considered for admission, we require the records from the last two reporting periods submitted by the parents. In addition we also require medical, psychological and Special Education records, if applicable. I allow the International School of Poznan to contact any previous school my child has attended should additional information be required.

CONTACT DETAILS FATHER s/guardian s NAME NATIONALITY PRIMARY LANGUAGE SPOKEN MOBILE NAME OF EMPLOYER WORK TELEPHONE HOME PHONE FATHER s/guardian s E-MAIL ADDRESS ADDRESS IN POLAND MOTHER s/guardian s NAME NATIONALITY PRIMARY LANGUAGE SPOKEN MOBILE NAME OF EMPLOYER WORK TELEPHONE HOME PHONE MOTHER s/guardian s E-MAIL ADDRESS ADDRESS IN POLAND MAIN CONTACT E-MAIL ADDRESS:. INVOICING DETAILS If you need an invoice for registration and tuition fees, please inform the assistant in the office and leave all necessary details. REGISTRATION AND TUITION FEES INVOICED TO.. DETAILS OF THE PERSON RESPONSIBLE FOR THE PAYMENT OF TUITION FEES/SCHOOL SERVICES: NAME: PHONE NUMBER: E-MAIL: Should any of the above details change, parents/guardians are obliged to inform the office immediately.

ISOP FEES POLICY I AGREE TO UNDERTAKE WITH THE SCHOOL AS FOLLOWS: 1. My child will regularly attend the school and conform to the school rules and regulations. 2. I accept the below stated terms of payment: ü I shall pay a non-refundable registration fee of 1650zł upon my child s admission to the school. ü The tuition and other school service fees are due and payable upfront by the fifth of each month (12 payments). In the final grade of the educational stage and in class "0", the yearly fees are divided into 10 payments and must be covered before certificates/ reports are distributed to students. ü The school may take action to terminate the student s enrolment if all due fees are not regularly covered. Such action does not relieve the parent/guardian of the obligation to pay the outstanding fees. ü Parents/legal guardians are held responsible for paying the school fees promptly. 3. I accept the below stated terms of withdrawal: ü For students leaving at the end of the school year, a written notice must be given to the Administration Office by the end of March. The parent/guardian remain obligated to pay all the year s school fees before the final reports/certificates are distributed. ü For students leaving during the course of the year: o July fee must be paid if the student leaves the school by the end of February o July and August fees must be paid if the student leaves during the second semester BANK ACCOUNT DETAILS ACCOUNT OWNER: FUNDACJA INTERNATIONAL SCHOOL OF POZNAŃ ul. Taczanowskiego 18, 60-147 Poznań BANK ZACHODNI WBK S.A. 2 ODDZIAŁ W POZNANIU Ul. Jugosłowiańska 10, 60-301 Poznań ACCOUNT NO: 41 1090 1346 0000 0001 0891 7662 SWIFT CODE: WBKPPLPP IBAN: PL 41 1090 1346 0000 0001 0891 7662

LANGUAGE QUESTIONNAIRE English is the language of instruction in Middle School at ISoP. Name of Student.. Primary language spoken by student.. Grade... Primary language spoken at home. Please indicate your child s level of English beginner intermediate fluent Knowledge of English (please give details).. Which foreign language(s) has your child studied? Language studied for (years) Language studied for (years) Middle School students choose a foreign language. Please choose one only. Spanish German PARENTAL COMMENTS ON APPLICANT The following information is important to help us determine if we can meet the needs of the applicant. Has the student repeated a grade? Yes No If yes, which one? Does the student have any special needs/learning difficulty? Yes No If yes, please fill in the space below*. *Please clarify the type of special needs: *Please give a detailed description of the type of learning support given to your child in/outside the classroom:.. Does the student have a statement of special needs? Yes No If yes, please enclose all relevant documentation with this application, including internal assessment if it has been made by any of the previously attended schools. Please indicate areas where you feel your child excels. and needs to improve

MEDICAL QUESTIONNAIRE Name of Student.. Birth date - - (DD) (MM) (YY) Address Grade... Place of birth (Town, Country).... PESEL/Passport No....... Underwent illnesses, surgeries.. Special treatment.. Allergies.. Health problems... Drugs being taken... Other... Please remember about vaccinations in your local clinic. Inform the school nurse about the vaccinations by handing in the child s health certificate or vaccinations card copy. The school nurse is responsible for preventive health care in our school. Therefore we ask for your permission for different health care programmes taken during the school year. Before any action is taken you will be informed about it via the school agenda. I agree for the following actions taken by the school nurse: Screening Yes No Doctor s check-ups Yes No Fluoridation Yes No Personal hygiene check-ups (head checks, etc.) Yes No