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Student Registration
Emerge Academy
Student Registration
Student Interest Form
Please fill out this form to express your interest in enrolling your child at Emerge Academy. We will review your application and contact you soon.
Child Information
Child's First Name*
Child's Last Name*
Child's Middle Name
Date of Birth*
Gender*
Select Gender
Male
Female
Desired Section/Class
Select Section (Optional)
Creche - Early childhood care for ages 0-2
Nursery 1 - Nursery class for ages 2-3
Nursery 2 - Nursery class for ages 3-4
Primary 1 - Primary school year 1
Primary 2 - Primary school year 2
Primary 3 - Primary school year 3
Primary 4 - Primary school year 4
Primary 5 - Primary school year 5
Primary 6 - Primary school year 6
Parent/Guardian Information
Parent's First Name*
Parent's Last Name*
Email Address*
Phone Number*
Address*
Emergency Contact Name
Emergency Contact Phone
Additional Information
Medical Conditions (if any)
Allergies (if any)
Additional Notes
Submit Application
Submit Application