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Student
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Level *
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Academic Year *
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Student Name *
Nick Name *
Gender *
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Place of Birth *
Date of Birth *
Passport No. *
Origin of Country *
Nationality *
Address *
Primary Language *
Number of Siblings *
Relatives in Indonesia *
No
Yes
Parent Information
(Father)
Name *
Place of Birth *
Date of Birth *
Last Education *
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Other
Occupation *
Monthly Earnings *
Phone *
Email *
Parent Information
(Mother)
Name *
Place of Birth *
Date of Birth *
Last Education *
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Occupation *
Monthly Earnings *
Phone *
Email *
Education Information
School Name *
School Address *
Year of Entry *
Graduation Year *
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Information
Blood Type
Weight *
Height *
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and Student Enthusiasm
Art, Sport, Organization, etc
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Term & Condition
We have read and agree to all school terms regarding the requirements for the recruitment of new students and our obligations if our child is accepted in Tazkia. All the informations in this registration document we fill in truth and can be used in accordance with the needs of the school
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