APPLLICATION FORM FORMULAR DE INSCRIERE THIS APPLICATION IS FOR (tick as appropriate) ACEST FORMULAR ESTE PENTRU A APLICA LA PANTELIMON CAMPUS
PIPERA EARLY LEARNING CENTRE
CHILD DETAILS INFORMATII COPIL First Name Prenume Surname Nume Date of Birth Data Nasterii Day Ziua
Gender Sexul
Month Luna
Male Masculin
Year Anul
Female Feminin
Nationality Nationalitate Current Year Level An Scolar Actual
Year Anul
Home Language Limbi Vorbite Acasa Home Address Adresa Actuala
Home Phone Telefon Acasa Requested Date of Entry to School and Year Group Data Solicitata Pentru Admitere si Clasa Day Ziua
Month Luna
Year Anul
Year Group Clasa
Preferred Language for Communication with Parents Limba de Comunicare Dorita cu Parintii
English Lb. Engleza
Romanian Lb. Romana
ACADEMIC INFORMATION INFORMATII ACADEMICE Previous schools attended (most recent first) Scoli anterioare(incepand cu cea mai recenta) School Name and Curriculum Type Numele Scolii si Programa Scolara
Contact Name, Number and Address Nume Persoana de Contact, Nr. Tel. si Adresa
From De La
To Pana La
City Oras
Names of siblings and year group Nume frati si clasa
Year Anul
Year Anul
Year Anul
Please tick the level of english proficiency of your child Va rugam bifati nivelul corespunzator al lb. Engleze None Zero
Fair Incepator
Intermediate Mediu
Fluent Fluent
Does your child have any areas of exceptional ability? Copilul dumneavoastra exceleaza intr-un anumit domeniu? Has your child ever received learning support? Copilul dumneavoastra a primit sprijin educational? Has your child ever had any individual/educational psychological testing? Copilul dumneavoastra a primit testare individuala/educationala psihologica? Has your child ever been classed as having any of the below? (please tick) A fost diagnosticat copilul dumneavoastra cu urmatoarele? (va rugam bifati)
Learning Disability Probleme Legate de Capacitatea de Invatare
Attention Deficit Disorder Deficit de Atentie
Behavioral Problem Probleme de Comportament
Physical Problems Probleme Fizice
Other information on circumstances or needs which may affect schooling relating to physical, social, religious, emotional or family circumstances (e.g Allergies, Dyslexia, Health Problems, Learning Problems, Disrupted Schooling etc.) Alte informatii privind imprejurarile sau nevoile care pot afecta scolarizarea (ex: Alergii, Dislexie, Probleme de sanatate, Probleme de invatamant, Perturbari in clasa etc.)
Father Tata
DETAILS OF PARENTS OR GUARDIAN INFORMATII PARINTI SAU TUTORI First Name Prenumele
Surname Nume
Occupation Ocupatia
Employer Angajator
Work Address Adresa locului de munca
Mother Mama
Mobile Phone Nr. Tel. mobil
Business Phone Nr. Tel. birou
Email Address Adresa de email
First Name Prenumele
Surname Nume
Occupation Ocupatia
Employer Angajator
Work Address Adresa locului de munca Mobile Phone Nr. Tel. mobil
Business Phone Nr. Tel. birou
Email Address Adresa de email
How will your child be coming to and from school? Cum va ajunge si cum va pleca de la scoala copilul? Parents/Guardian Cu Parintii/Tutori
School Transport Busul Scolii
Public Transport Transport Public
Other Alte
Please state names of those who will be collecting your child (We may need a photo and/or ID card copy) Va rugam sa mentionati numele celor care vor prelua copilul (Se poate sa va cerem o poza si/sau copie act identitate)
Native Nativ
RESPONSIBILITY FOR SCHOOL FEES RESPONSABIL PENTRU PLATA TAXELOR SCOLARE Person or organization responsible for payment of school fees Persoana sau organizatia responsabila pentru plata taxelor Accounts / Invoice for the attention of Facturi in atentia Contact name and telephone number Persoana de contact si numar de telefon Company compania
Parents Parinti
Bank Transfer Transfer Banca
Cash Cash
Currency of payment Moneda de plata
Euro Euro
RON RON
Duration of payment Durata platii
In Full Integral
4 Installments 4 Rate
Yes Da
No Nu
Daily Menu Meniul Zilei
Open Menu Meniu la Alegere
(va rugam bifati)
Method of payment Metoda de plata
TAXA DE MASA
School lunches required Se doreste masa asigurata
(va rugam bifati)
(please tick)
SCHOOL LUNCH
(please tick)
TAXE SCOLARE
SCHOOL FEES
Responsible for school fees Responsabil pt. plata taxei scolare
Menu (Secondary School) Meniu (Secondary School)
Cheque Ordin de Plata
8 Installments (If registered by September) 8 Rate (Daca inregistrarea se efectueaza pana in Septembrie)
DECLARATION BY PARENT/LEGAL GUARDIAN SUBMITTING THIS APPLICATION DECLARATIA PARINTELUI/TUTORELUI LA MOMENTUL DEPUNERII ACESTUI FORMULAR I, ________________________________________________ apply for the named child to be registered. I understand that admission cannot take place unless documents required by the school are submitted and acceptance is confirmed by the Admissions officer. I agree with the school policies which are also available on the school website http://www.isb.ro Subsemnatul(a), ________________________________________________ aplic pentru ca si copilul mai sus mentionat sa fie inscris. Inteleg ca inscrierea nu poate avea loc decat daca toate documentele necesare inscrierii sunt depuse si acceptul este oferit de catre ofiterul de inscrieri. Sunt de acord cu politicile scolii, care se gasesc pe site-ul http://www.isb.ro
Date Data
Signature Semnatura
FOR OFFICIAL USE
Date of receipt of application Day
All documents received
Status of EFL/Entrance Assessments Finance Information
Approved by Principal
Yes
Month No
Year
Main Campus Pantelimon Sos Gara Catelu, Nr.1R, Sector 3 032991, Bucharest +40(21) 306 95 30 +40(21) 306 95 34 (fax) info@isb.ro
Early Learning Center Pipera Sos. Pipera-Tunari, Nr.82, Voluntari 729951, Jud. Ilfov +40(21) 267 42 18 +40(21) 267 42 19 (fax) admissions@isb.ro