Admission Form - Concordia International School

Personal Details of Applicant

Applying for Grade

School Year

First name

Middle name

Last name

Date of Birth

Place of Birth

Phone

Gender

Nationality

Native Language

Other Languages(In order of fluency)

Please provide photocopies of your passport and HKID card

Passport Number

Issuing Country

Passport Expiry Date

If not Hong Kong passport holder:

Visa Status

Visa Expiry Date

HKID Number

Family Information

Applicant will be living with:

Father / Guardian

Preferred form of correspondence:

Surname / First Name

Mobile Phone Number

Address

Father's Occupation

Father's Company

Mother / Guardian

Preferred form of correspondence:

Surname / First Name

Mobile Phone Number

Address

Mother's Occupation

Mother's Company

Siblings

Please list siblings' names, dates of birth and their current school.

Name

Date of Birth

Current School

Educational Details of Applicant

Currently in grade

Current School Name

School Address

Educational History

Please list the name and details of your last two schools:

School Name

Country

Language taught in

Grade

Date From to

Special Educational Needs

Has the applicant ever seen any of the following specialists? If yes, please attach reports when supporting
documents are requested.

Has the applicant ever been included in a "gifted and talented" program?
NoYes

Has the applicant ever seen any of the following specialists? If yes, please attach reports.
Speech TherapistOccupational TherapistEducational PsychologistLearning Support Teacher
Parents/Guardians of applicant are to provide information concerning their child ability
to learn in regular school environment. Withholding or providing false/misleading information may affect
continued enrolment and refund policies. School administration's decision is final in this regard.

Payment Details

Bank Transfer Reference (for online payments)

HKD 1000 towards Application processing fee:
Account details: HSBC #193-072311-001