Please email your child’s recent photo as a JPEG image file to festivalnaya@atlanticschool.ru
or attach a photo here. (Do not staple or glue)
Registrar’s Office
115088, Moscow, Sharikopodshipnikovskaya Street, 30A Block 1 www.atlanticschool.ru | Tel.: +7(495) 661-8691 | Fax: +7(495) 661-8692 Applications for Atlantic International School must be returned to the AIS Registrar of the applied school. Please type or print in black ink.
Application for Admission Personal Data (Student)
01 Family Name
02 First Name
03 Middle Name
04 Mother’s full name
05 Father’s full name
06 Birth date
07 Place of birth (City/Country)
08 Citizenship(s)
09 Gender
10 Campus Applied for AIS Dubrovka AIS Skolkovo
■ Male
Female
11 Expected enrollment date (DD/MM/YY) AIS Festivalnaya AIS St.Petersburg
01/01/2011
12 Student resides with (check all that apply)
Mother
Father
Stepmother
Stepfather
Other legal guardian
13 Name and telephone number of Translator (required if parents are not fluent in English or Russian)
14 Name of Sibling(s) Age Current School
15 Does your child have any medical concerns that the school should know about? If so, please provide details.
Yes
No
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
page
1