Online Student Registration Form - Khalifah Model School
Registration Information
Application For School *
For Intake Year *
For Level Form/Year *
Preferred Session* Preferred Session Will Be Finalized By Management
Previous School
Student Information
Student Name*
Citizen
IC No/Passport* (No Space and Dash '-')
Birth Cert. No
Birth Place* Others
Birth Date*
Gender/Race/Religion*
Tel. Mobile* (Parent) (No Space and Dash '-')
Email (Parent) Eg. mel@yahoo.com
Tel. Home
Address (Line 1)*
Address (Line 2)
City*
Postcode* Others
Illness/Alergic

 Others (Specify) :  
Untitled Document
Guardian / Father Information
Name*
IC No / Passport*
Relation*
Occupation
Salary* (RM)
Education
Employer
Address
Tel. Mobile (No Space and Dash '-')
Tel. Home
Tel. Office Fax:
Email Eg. mel@yahoo.com
Mother Information
Name*
IC No / Passport*
Relation*
Occupation House Wife (Click)
Salary* (RM)
Education
Employer
Address
Tel. Mobile (No Space and Dash '-')
Tel. Home
Tel. Office Fax :
Email Eg. mel@yahoo.com
Family Information
  Name School/College/Job Birth Year
1.
2.
3.
4.
5.
6.
7.
8.
For Emergency Contact (Beside Parent)
 Name*
 Relation*
 Tel. Mobile* (No Space and Dash '-')
 Tel. Home
 Tel. Office
 Fax
 Email Eg. mel@yahoo.com
Others Information
How do you know about us

 
ADMISSIONS AND REGISTRATION
 
Where places are available (i.e. number of students per class have not exceeded the maximum capacity as per policy), admission of students into Khalifah Model  School is subject to a satisfactory assessment and interview. 
 
The acceptance of the Offer must be made prior to the child’s commencement of school. The payment of the required Registration and Deposit constitutes the acceptance of a place and therein CONFIRMS the place for the child. 
 
Where places are not available, applicants are placed on a waiting list for admissions in chronological order according to the date on which the School receives the completed Application Form with the required documents and Application Fee. However, the School reserves the right to refuse admission for any reason we deem fit. 
 
If you require further clarifications, please do not hesitate to contact our Admissions Department. 
 
ACKNOWLEDGEMENT
 
I, parent/guardian of the student above, hereby declare that, I have fully read and understood all the terms and conditions/ general notes mentioned above and confirm to abide by all the terms and conditions.
 
I hereby verify that all information on this form is true and correct. Khalifah Model School has the right to reject any incomplete application without notice.