Zikura Learning CentreApplication Form

1. PROGRAMME INFORMATION

Select a course from this list of programmes offered

2. STUDENT PERSONAL INFORMATION

Student Name

Date of Birth

ID Card No

Gender

Are you currently enrolled in primary school or secondary education program, such as O-Level or A-Level?

Yes

School Session

School Grade

Contact No.

Viber No.

Permanent Address

Atoll

Island

Present Address

Same as permanent Address

Other

3. Parent/Guardian Details

Full Name

Relationship with Student

Contact No.

Viber No.

Present Address

Permanent Address

Emergency Contact Details

Full Name

Relationship with Student

Present Address

Contact Number

4. Required Documents

ID Card

Application Fee: 100/-

Account Number: 7770000009216 (Zikura School)

Student's Picture

Transfer Slip

5. Declaration

I Agree

Statements on this form which prove to be untrue or purposely misleading will cause the form to be cancelled. I confirm that the information given in this form is true, complete, and accurate, no information requested or other material information has been omitted.