Admission Form

Crose Secondary School

#15, New Jerusalem, Road 6, Off Pipe Line, Rumukwurusi, Port Harcourt.
2348169950123
info@c-roseacademy.com

Admission Form

Photo

Basic Information:

Student Name:
Student Type:
Birth Date:
Gender:
Religion:
Caste:
Blood Group:

Contact Information:

Phone:
National ID:
Present Address:
Permanent Address:

Academic Information:

Class:
Section:
Group:
Second Language:

Previous School:

School:
Class:

Father Information:

Father Name:
Father Phone:
Father Education:
Father Profession:
Father Designation:

Mother Information:

Mother Name:
Mother Phone:
Mother Education:
Mother Profession:
Mother Designation:

Other Information:

Email:
Health Condition :
Other Info:

Guardian Information:

Guardian Name:
:
Phone:
Email :
Religion:
Profession :
National ID:
Present Address:
Permanent Address:
Other Info:
Online Admission

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