Online Application Form - BASIS International School Bangkok

Student First Name (Given) *

Student Middle Name

Student Last Name (Family) *

Nickname

Student Date of Birth *

Student Country of Birth

Student Gender *MaleFemale

Current Grade Level *

Incoming Grade Level *

School Year *

Student Primary Language *

Student Secondary Language *

English Proficiency *

Currently Resides *

Nationality

Permanent Residence

Student Passport Number

House Number *

Building/Village/Condo *

District *

City/Province *

Zipcode *

Country

Use student address as same

Title

First Name (Given) *

Last Name (Family) *

LINE ID *

Phone *0 / 10

Email *

Country of Birth

Residency *

Citizenship *

Passport Number *

Relationship *

Does the applicant live with this Parent/Guardian? *

Does this Parent/Guardian have custody/legal guardianship of the applicant? *

Is this Parent/Guardian the primary contact regarding admissions? *

House Number *

Street/Road *

Building/Village/Condo *

Sub-district *

District *

City/Province *

Zipcode *

Country

Field of Work

Job Title

Employer

Use student address as same

Prefix

First Name (Given)

Last Name (Family)

LINE ID

Phone

Email

Country of Birth

Residency

Citizenship

Passport Number

Relationship

Does the applicant live with this Parent/Guardian?

Does this Parent/Guardian have custody/legal guardianship of the applicant?

Is this Parent/Guardian the primary contact regarding admissions?

House Number

Street/Road

Building/Village/Condo

Sub-district

District

City/Province

ZIP

Country

Field of Work

Job Title

Employer

Current School *

School Type *

Has your child ever received special help or attended special classes for any learning, social, emotional, or behavioral difficulties? *NoYes

If yes, please elaborate

Has your child ever been involved in a serious disciplinary incident(s) resulting in a response (e.g. suspension or dismissal) from school? *NoYes

When and why?

Does this student have additional support needs or physical disabilities? *NoYes

Please elaborate

Do you need school bus services? *

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Sibling 1

First Name (Given)

Last Name (Family)

Nickname

Gender

Age

Grade level

Current BASIS School (if applicable)

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Sibling 2

First Name (Given)

Last Name (Family)

Nickname

Gender

Age

Grade level

Current BASIS School (if applicable)

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Sibling 3

First Name (Given)

Last Name (Family)

Nickname

Gender

Age

Grade level

Current BASIS School (if applicable)

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Emergency Contact 1

First Name (Given) *

Last Name (Family) *

Nickname

LineID

Phone *

Relationship *

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Emergency Contact 2

First Name (Given)

Last Name (Family)

Nickname

LineID

Phone

Relationship

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Please provide the following documents: your child's birth certificate, child's passport photo, and parent's passport. Documents can only be in the following formats: PDF, GIF, TIFF, and JPG. Each file can be a maximum of 3MB in size.