Please fill in the form and submit at the school premises with copy of Bank Teller to reserve slot(s) for your child(ren). (Pay in total sum but fill a form per child) Registration Fee: N6,000 Bank: Zenith Bank Plc Acct. Name: MAVIS ACADEMY LIMITED Acct. No: 1015163559

RC: 1409426

MAVIS ACADEMY APPLICATION FORM Pupil Information

Select School Location: Mpape, Abuja

Name First Name

Birth Date Day Month

Middle Name

Nationality

Surname

Gender Male Female

Year

Mararaba, Nasarawa

Language spoken at home

Religion

Preferred Language of Instruction

Pupil Earlier School Information Were you in a school before? Yes

No

Name(s) of School & Town(s)

(If ‘No’, go to Guardian Information) Period of Study (e.g. 2014/2015)

Class

Present Class

Guardian Information Name First Name

Gender Male Female

Surname

Occupation

Relationship to the Pupil E.g. Mother/Father/Guardian

Phone Number

Email www.maviseducation.com | [email protected] | 08036535050, 08071524680

Home Address

Office Address

Child’s Height

Child’s Weight

Does the child have any Medical Challenge? If yes, specify in the box to the right.

Signature & Date

-------------------------------------------------------------------------------------------------------------------------For Official Use: Date received

Reviewed By

Date of Assessment

Year Group

Place offered

Start

Note: You can also send a scanned copy of this completed form and the bank teller (or transfer confirmation) to [email protected] if it is more convenient than dropping it at the school premises.

www.maviseducation.com | [email protected] | 08036535050, 08071524680