Day Waterman College

Section A

Student Last name *:

Student First name *:

Student Other name :

Home Address *:

Date of Birth *:

Sex :

Language(s) Spoken *:

Parents/Guardian's Contact details

Father's Name *:

Full residential address :

Father Occupation :

Email address *:

Nationality :

Country of residency :

Mobile Telephone *:

Home Telephone :

Place of work :

Work Telephone :

Father's office address :

Mother's Name:

Full residential address :

Mother's Occupation :

Email address:

Nationality :

Country of residency :

Mobile Telephone *:

Home Telephone :

Place of work :

Work Telephone :

Mother's office address :

Section B

Name of previous/current school i *:

Name of Head Teacher *:

Phone number of School *:

Email address of Head Teacher:

Phone number of Head Teacher :

Current Class:

ii :

Name of Head Teacher:

Phone number of School:

Email address of Head Teacher:

Phone number of Head Teacher :

Current Class:

iii :

Name of Head Teacher:

Phone number of School:

Email address of Head Teacher:

Phone number of Head Teacher :

Current Class:

Last class attended :

Upload scan copy result of last promotion Examination :

Class for which admission is sought *:

Section C

Additional emergency contact Name of emergency contact *:

Full residential address :

Occupation :

Email address *:

Nationality :

Country of residency :

Mobile Telephone *:

Home Telephone :

Place of work :

Work Telephone *:

Work office address :

Guardian in Nigeria if parents live abroad Full name of guardian :

Full residential address :

Occupation :

Email address :

Nationality :

Country of residency :

Mobile Telephone :

Home Telephone :

Place of work :

Work Telephone :

Work office address :

Does your child have any learning support requirements Does your child have any learning support requirements :

Yes

My child has been assessed for dyslexia and/or specific learning support requirements :

Yes

He/She has been receiving extra one-to-one support or small group tuition :

Yes

He/She has on educational Psychologist's report(if Yes, Please enclose a copy with this Application Form) :

Yes

My child has extra time or other access arrangements in examinations. :

Yes

(Any information you give will be treated confidentially and forwarded to the Head of Learning Support,who may contact you for discussion.) Please provide all documentation including medical reports in respect of the above.

Does the student have any form of allergy? :

Does the child have any form of allergy? If yes, please give details :

Name and Address of student's sponsor :

Additional student details *:

Are you applying for an indigent Student Scholarship :

Yes

Section D

Head Teacher's remarks about the student :

Upload passport size photograph of the child *:

Upload photocopies of birth :

How did you hear about Day Waterman College ? *:

Independent school's directory

Parent school

Local Knowledge

Advertisement/Press article/TV/Radio/Internet

Friend/Relative/Sibling

School Staff(Please State)

Other School Parents(Please State)

Other (Please State)

Declaration We request that our above named child be registered as a prospective student of Day Waterman College. We understand that the Terms and Conditions of the School will undergo reasonable changes from time to time as circumstances require which will apply in all our dealings with the School. We also understand that the School may obtain, process and hold personal information about our child, including confidential information such as medical details,and we consent to this for the purposes of assessment of our child and, if a place is later offered, in order to safeguard and promote the welfare of our child

I declare that the information furnished by me in this form is correct to the best of my knowledge.

First Signature:

Second Signature :

Printed name in full *:

Printed name in full :

Relationship to the child *:

date *:

We give permission for photographs of our child/ward taken at school to be used for school marketing purposes e.g. prospectus,website,newspapers etc. *:

Yes

Please note that early application is recommended. Applications will be considered in order they are received. Offers of places are subject to availability and the admission requirements of the School at the time. A copy of the current Admissions Policy and Terms and Conditions is available on our website.

Admission office : Day Waterman College Abeokuta – Sagamu Expressway, Asu Village Road, Abeokuta – Ogun State, Nigeria 07056780016 Lagos Liason Office 18b Thompson Avenue, Ikoyi – Lagos, Nigeria 2793836 -7

Telephone : 08058698081, 08058698071

E-mail : admissions@dwc.org.ng

Please indicate exam center of choice *: