European School of Goa

1 Personal Information

Photo *

Full Name *

Nickname

Gender

Date of Birth *

Nationality

Applying for which Level

Phone *

Email *

2 Family Information - Please list all siblings

#	Sibling Name	Date of Birth
1

Child(ren) Lives With

Other: Please specify name and relationship to child

Residence Address *

3 Emergency Contact

Please do not list the child’s mother or father; this should be an extended family member, colleague, neighbor, nanny, etc… someone you trust to take care of your child(ren) in the event the school is unable to reach either parent.

Name *

Relationship *

Mobile *

Telephone

4 Family nannies and drivers

(NAMES AND MOBILE NUMBERS) who pick up your child from school: (attach copy of ID for each)

#	Full Name	Mobile	ID Copy (PDF only)
0
1

5 Parents Information

Father's Name *

Father's Mobile

Father's Native Language

Father's Email

Mother's Name *

Mother's Mobile

Mother's Native Language

Mother's Email

6 Academic History

List all the schools your child has attended starting with the current or the one last attended:

School Name & Country	Grade Enrolled & Date	Grade Completed & Withdrawal Date	Language of Instruction

Major Language Used at Home *

Other Languages Spoken

7 Health Information

Medical Conditions

Allergies

8 Upload Documents

Student Passport (PDF only, max 5MB) *

Recent School Report (PDF only, max 5MB)

9 Privacy

Tick this box if you are comfortable with other parents having access to your contact details for communication purposes, or leave it unchecked if you prefer not to.

Admission