Phelim High Schools

42/44 ADESUWA GIRLS GRAMMAR SCHOOL ROAD, G.R.A; BENIN CITY.  Edo State, Nigeria.

2-4 OSARETIN ASEMOTA STREET, OFF UGBOR ROAD, G.R.A; BENIN CITY Edo State, Nigeria.
 

1 . CHILD'S INFORMATION

LAST NAME           FIRST NAME  

MIDDLE NAME         ADDRESS    

DATE OF BIRTH        AGE GENDER  MALE FEMALE

Class The Child is seeking Admission Into 

2 . PARENT INFORMATION

   MOTHER  FATHER
NAME
OCCUPATION
OFFICE ADDRESS
OFFICE TELEPHONE
HOME ADDRESS
HOME PHONE
     

3 . RESPONSIBLE FRIENDS/RELATIVE TO CALL IF PARENTS CANNOT BE REACHED.

   
NAME 1
TELEPHONE
NAME 2
TELEPHONE
NAME 3
TELEPHONE
   

4 . NAMES OF ALL PERSONS AUTHORIZED TO REMOVE CHILD FROM SCHOOL

   
NAME 1
TELEPHONE
NAME 2
TELEPHONE
NAME 3
TELEPHONE
   
   DATE ( day/month/year)   DATE ( day/month/year)