The Chrysalis · Registration Form

🎯 Programme

Which programme are you registering for?

🏫Main School

Full-time enrolment

📚After-School

Learning centre

☀️Holiday Tutorials

9am–12pm

Preferred Learning Plan *

💻 Online 🏫 Offline (Physical) 🔄 Hybrid

👶 Child's Details

Child's First Name(s) *

Child's Surname *

Child's Age *

Date of Birth *

Child's Sex *

Blood Group (if known)

Class *

Placement is determined by the age your child reaches by the end of August of the admission year.

Name of Previous/Current School *

Address of that School

Home Address *

👨‍👩‍👧 Parents / Guardian

Father's Mobile Number(s) *

Father's Email Address

Mother's Mobile Number(s) *

Mother's Email Address *

Home Line

Alternative Phone (Guardian) *

Relationship with the Guardian *

Emergency Contact (name & number)

🏥 Health History

Please indicate any health challenges your child has experienced.

Allergies & medication details (if any)

Any other health concerns we should be aware of?

🧩 Child's Learning History

Please indicate any challenges experienced in your child's learning journey.

Please give more details about any challenges mentioned above.

🤝 Previously Recommended Support

Has your child seen or been placed on any of the following?

💭 Expectations & Additional Info

Parent's Expectations *

Areas of learning you'd like more focus on

Parent's Concern *

Anything else you'd like to share?

Preferred Start Date

How did you hear about us?

Parent's Signature (Dad or Mum) *

I consent to photographs of my child being used for daily reports and school records.

📎 Documents to Send

Kindly send copies of the following (via WhatsApp after submitting, or email):

4 recent passport photographs
Birth certificate
Last term's report from previous school
Biodata page of international passport (for international students)