Application Form

 
 
Print this page, fill in the details and fax it to us.
 

              

Goroka Grammar School

P.O. Box 1494 
Goroka,
Eastern Highlands Province,
Papua New Guinea
Telephone: (675) 732 2559
Fax:(675) 732 2559
Email: ggs@daltron.com.pg

 
 
                                              APPLICATION  FOR  ENROLMENT
 
1.  STUDENT  INFORMATION                                                           Date:     ______________
 
Surname:   ________________________                    Given Names:   ________________________
 
Gender:             Male / Female:   ______________                              Grade:   ______________
 
Nationality:   ________________________
 
Address:       ________________________________________________ 
 
                     ________________________________________________ 
                  
    
PHONE:                Home:     ________________________
 
                               Father:   ________________________
 
                               Mother:   ________________________
 
Date of Birth:   ________________________                                        Age:   ______________
 
Religion:          ________________________
 
Previous  School:   ________________________________________________ 
 
________________________________________________________________________________________________   2.      FAMILY  INFORMATION
 
Father's  Name:     ________________________
 
Occupation:            ________________________
 
Mother's  Name:     ________________________
 
Occupation:            ________________________
 
Guardian's Name:  ________________________                              Phone:   ______________
 
________________________________________________________________________________________________     3.      ESSENTIAL  INFORMATION
 
Is there any information regarding your son's / daughter's health, educational or social development that the school should know about?
 
________________________________________________________________________
 
________________________________________________________________________
 
________________________________________________________________________  
 
________________________________________________________________________
 
 

________________________________________________________________________________________________     4.      STATEMENT  OF  CONSENT

 
I give permission for my son / daughter to take part in Official School Excursions and Sports Activities. If there are limitations to the above, please specify.
 

________________________________________________________________________

________________________________________________________________________
 
________________________________________________________________________

________________________________________________________________________

     
 
 
 
Signed:   ________________________
                           Parent / Guardian
 
  ________________________________________________________________________________________________      
NOTE:       A  non-refundable deposit of K400.00  is required to secure enrolment. This will be deducted from fees when full payment is made. Fees can be paid direct to the school account on: 11270022 at ANZ bank,  Goroka.
 
 

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