Please fill in your child's basic information. We will contact you further to initiate the registration process.

CHILD'S PERSONAL DATA /  DATA PRIBADI ANAK

NAME /  Nama Lengkap :
The name used for the certificate (according to birth certificate)
Nama yang digunakan untuk ijasah (sesuai akte)

First Name /  Nama Depan :
Middle Name /  Nama Tengah :
Family Name /  Nama Keluarga :
Date of Birth /  Tanggal Lahir :

  • Date /  Tanggal :
  • Month /  Bulan :
  • Year /  Tahun :


Place of Birth /  Tempat Lahir :

City /  Kota :
Province /  Propinsi :
Country /  Negara :
Address /  Alamat :
Postal Code /  Kode Pos :
Phone /  Telepon :
Fax /  Faksimili :
E-mail /  E-mail :
Previous School /  Sekolah Asal
Entry Grade /  Masuk di Kelas :

•   PG  Grade
•   TK  Grade
•   SD  Grade
•   SMP  Grade
•   SMA  Grade
Location /  Lokasi :

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