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Online Application
Please enable JavaScript in your browser to complete this form.
1
Student Information
2
General Information
3
Parent Information
4
Document Submission
Student Information
Student’s Name (On ID/Passport)
*
First
Middle
Last
Nickname
Date of Birth (DD/MM/YYYY)
*
Anticipated Starting Date(DD/MM/YYYY)
Gender
*
Male
Female
Nationality
*
ID/Passport No
*
Email
*
Mobile:
*
Language(s) Spoken at Home
*
Religion
*
Home Address in Thailand
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Phone Number(s)
First
Middle
Last
Previous School Attended
( from & to) - only put MM/YY format
(Thai School, Bilingual, British, American, etc.):
Please submit with this application
1 passport-size photo of your child
1 passport-size photo of each parent/guardian
1 passport-size photo of guardian, driver or person authorized to collect your child from school
Copy of child’s passport/ID (ID page with non-immigrant visa page, if applicable)
Copy of each parent/guardian’s passport/ID (ID page with non-immigrant visa page, if applicable)
Copy of house registration (for Thai nationals only)
Completed “General Health Form” (see attached document)
Previous school records
School Transfer Certification from previous school
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General Information
Health:
Does your child have any vision problems?
*
Yes
No
Not sure
Does your child have any hearing problems?
*
Yes
No
Not sure
Do you have any concerns about your child’s speech?
*
Yes
No
Not sure
Does your child have any learning disabilities?
*
Yes
No
Not sure
Does your child have any physical health limitations?
*
Yes
No
Not sure
Has your child ever suffered from any serious illnesses?
*
Yes
No
Not sure
Has your child ever been evaluated by an education psychologist or specialist?
*
Yes
No
Not sure
Does your child have any serious behavioral problems or issues?
*
Yes
No
Not sure
If yes to any above, please explain
Eating Habits:
Does your child have any food allergies?
*
Yes
No
Not sure
Does your child have any dietary restriction for religious reasons?
*
Yes
No
Not sure
If yes to any above, please explain..
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Parent Information
Parent 1
*
Mother
Father
Other
Name
*
Nationality
*
Native Language
*
Mobile Phone
*
Email
........................................
Parent 2
Mother
Father
Other
Name
Nationality
Native Language
Mobile Phone:
Email
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Next
Documents Uploads
Please submit the following by uploading here
(NB: .jpg,.jpeg format only , maximum file size 500KB)
Passport-size photo of your child
*
Passport-size photo of each parent/guardian
*
Passport-size photo of guardian, driver or person authorized to collect your child from school (if applicable)
Copy of child’s passport/ID (ID page with non-immigrant visa page, if applicable)
Copy of each parent/guardian’s passport/ID (ID page with non-immigrant visa page, if applicable)
Copy of house registration (for Thai nationals only)
Completed “General Health Form” (see attached document)
Previous school records
School Transfer Certification from previous school
Declaration
*
I acknowledge that the above information is complete and true to the best of my knowledge. I give full consent to Centurion International School to contact my child’s previous school. Furthermore, I have read the Centurion Parent Handbook and agree to comply by the rules and regulations started within it.
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Submit