NAIROBI INTERNATIONAL SCHOOL

ADMISSION APPLICATION FORM

ABOUT THE STUDENT

Family Name

First Name

Photo
Male

Female

Nationality

Birth Date: Year Month Day Please send this application form
to:
Mailing Address City The Admissions Department
P.O. Box 66831 - 00800
Nairobi, Kenya.
Postal Code Country
Phone: +254 - 20 - 2154672 /
2543566 / 67
Home Phone Mobile Phone
Cell: 0736 264 475 / 0727 379 149
Email: [email protected]
Fax E-mail Website: www.nis.ac.ke

EDUCATION

Previous School Attended Year / Class Completed

ADMISSION

Class to which admission is being sought To Start SEPTEMBER / JANUARY / APRIL

ABOUT THE PARENT OR LEGAL GUARDIAN AND FINANCIAL SPONSOR

Mr. Mrs. Miss Nationality

Family Name First Name

Profession

If you reside in Kenya, please specify if you have a: Kenyan Citizenship Work permit

Mailing and Physical Address

City Postal Code Country

Home Phone Work Phone

Mobile Phone Fax

Email
 VERY IMPORTANT *Please return this form duly filled in, and enclose the following:

• Official copy of your previous School Leaving certificate. • 1 Photocopy of your valid passport showing your name & nationality

• Official copy of your final transcripts. • Duly filled in, signed & stamped Medical Certificate or Physician

• A short essay of about 205 words about yourself. Report if necessary.

• 2 passport size photographs.

ACADEMIC PROGRAMMES

I wish to enroll for the following academic programme (one choice only)

JUNIOR SCHOOL IGCSE

Play Group YEAR 1 YEAR 4 YEAR 10 YEAR 11

KG 1 YEAR 2 YEAR 5

KG 2 YEAR 3 YEAR 6

MIDDLE SCHOOL A LEVELS

YEAR 7 YEAR 8 YEAR 9 AS / GRADE 12 YEAR 11

I wish to start my studies in: September 20 January 20

HOW DID YOU HEAR ABOUT US?

Student Internet Parents

Promotion Media Billboards

Other, please specify

*Please give the name

MOTHER TONGUE AND ENGLISH LEVEL

If English is not your mother tongue or if you have not spent at least 3 years in an english speaking school, please indicate:

Languages you are fluent in Your Mother Tongue

LAPTOP OPTION

I will bring my own laptop which meets Institution’s requirements I would like to purchase the laptop through NIS payment plan

SERVICES

a) Lunch is Mandatory

b) Transport required One - Way Two - Way

Pick up / Drop off point

c) I require accommodation arranged by NIS Yes No

My Blood Group is

Have you ever had or do you suffer from:

No Yes (if yes, when) No Yes (if yes, when)

Tuberculosis Psychological Disorder

Hepatitis A/B/C Sleeping Disorder

Sickle Cell Anaemia Eating Disorder

• For the following points, please specify if you:

• Have any other disease or have had an operation recently

• Have dyslexia or other learning problems (indicate to what degree)

• Have allergies to any medicine or other products

• Take any medication on a regular basis

• Take or have taken antidepressants

• Are on a special diet

• Have had any accident with mental or physical consequences

With regards to any of the above special needs or medical conditions you may require, NIS aims to create an enviroment which enables all students to
contribute fully in the School life. To help us make reasonable adjustments, it is imperative to clearly indicate your special needs (i.e.dyslexia) or medical
condition. Please note that consideration of how we can meet any special needs is separate to the assessment of your academic sustainability.

How would you describe your general health condition?

Excellent

Very Good

Good

Poor

In keeping with the School’s policies regarding the prevetive health measures, the School Director may request a student to undergo a medical checkup
at any time during his / her studies at NIS.

Signature of the applicant Date

Signature of the parent or legal guardian Date

I hereby certify that all information given on this form is exact and complete. I acknowledge having read and understood this document, (available from the
website www.nis.ac.ke) which includes the Handbook, the Rules of NIS as well as the payment terms and conditions. I agree to abide by them as well as the
specific “NIS“ regulations. I understand that the fees are modified when absolutely necessary. I hereby agree to give ONE TERM’S notice in case of
withdrawal of my child from your school, failure to which i will pay a TERM’S FEE in lieu of notice. I hereby agree that NIS may obtain, in emergency,
medical treatment for my child should it not be possible to contact the parents. I promise to make good any such expenses incurred.

Signature of the Parent/Financial Sponsor

Date

APPLICATION FEE

Please find enclosed Cash / Cheques No. of Kshs 15,000/- towards the Application Fee.

Name

Signed

Date

FOR OFFICIAL USE ONLY

DATEOF ADMISSION :

ADMITTED TO YEAR :

HOUSE NAME :

VERIFIED BY : DATE :