PAT'S Schoolhouse

CHILD'S PARTICULARS

ID No

ID Type BC FIN UIN

First Name

Last Name

Hanyu Pinyin

Nationality

Race

Date of Birth (d/m/yyyy) / / Present Age

Place of Birth

Gender Female Male

Birth Order 1st 2nd 3rd

Number of Siblings 1 2 3 4

Previous Care Arrangements

Parents Relatives Nanny Childcare Centre Others (Pls specify)

Person you authorise to pick up your child other than you, yourself or driver

Name

NRIC

Relationship

Transport Information

Transport Type Car Bus Others Vehicle No

Contact No in case of emergency (in the event that you or your spouse could not be reached)

Name

Telephone

Contact No of child's/family doctor

Name

Telephone

Special instructions concerning child (Please state allergies if any)

Share with us your child's habits, character traits & interests.

Preferred date of commencement (d/m/yyyy) / /

Centre

Arena Buckley Claymore Halifax
Katong Mount Emily Ridgewood Serangoon Siglap Baby Haven @ 3 Halifax

Session AM PM Full Day Flexi

How you came to know about Pat's Schoolhouse
Friends Media Signboard Others

FATHER'S PARTICULARS

Name as in NRIC

NRIC/Passport No

Date of Birth (d/m/yyyy) / /

Race

Nationality

Occupation

Employer's Name

Employer's Address

Business Telephone

Pager/Handphone

Email Address

Home Address

Home Telephone

Mailing Address (if different from above)

MOTHER'S PARTICULARS

Name as in NRIC

NRIC/Passport No

Date of Birth (d/m/yyyy) / /

Race

Nationality

Occupation

Employer's Name

Employer's Address

Business Telephone

Pager/Handphone

Email Address

Home Address

Home Telephone

Mailing Address (if different from above)

Thank You for registering your child with us!

Please note that places are subject to availability. However, you can call us at +(65) 6296 2668 or email us at contact@patschoolohouse.com to check on the status of your registration.