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Summer School Application
STUDENT APPLICATION
SUMMER SCHOOL
PERSONAL DATA
Name in Arabic in accordance with residency papers for Non-Arabs.                                   ÇáÇÓã ÇáßÇãá æÝÞÇ áÈØÇÞÉ ÇáåæíÉ

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ÇáÔåÑÉ
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Family Name: First Name: Middle Name:
Date of Birth: Place of Birth: Country: Sex:
Nationality(ies): Passport ID no.:
Nationality(ies): Passport ID no.:
First Language:                        Other Language:
Home Address
Street:       Building:     Floor:
Town/City:       Country:
POBox:
Home Tel/Fax:
PARENTAL DATA
FATHER’S INFO
First Name: Last Name:
Profession: Company:
Work Address:
Work Tel:   Ext:
Mobile Tel:
Fax:
E-mail:
MOTHER’S INFO
First Name: Maiden Name:
Profession: Company:
Work Address:
Work Tel:   Ext:
Mobile Tel:
Fax:
E-mail:
Where did you hear about us:
Advertisment: (please specify)       A friend: (please specify)
Website:
SCHOOL ATTENDING
Name:     Grade:     Country:
SUMMER SCHOOL ATTACHMENT
Individual Program
Family Name: First Name: Middle Name:
Academic subjects:          Amount:
Days of the week:
Special Notes:
Activities:          Amount:
Days of the week:
Special Notes:
Boarding:          Amount:
Pocket Money: weekly amount:          Amount:
Special Notes:
Will your child be riding the bus?     Yes     No
Who is responsible to pick up your child?
Number of weeks:
Staring date:      Ending date:
Total Due:
Blood Type:
Does your child have any health/medical conditions?     Yes     No
If yes, please submit medical record.
Does your child have any allergies?     Yes     No
If yes, please submit medical record or information.
EMERGENCY CONTACTS
Guardian’s Full Name:
Relationship to the Child:
Address:
Tel. No.:
Other Contact’s Full Name:
Relationship to the Child:
Address:
Tel. No.:
I hereby submit the following application for admission to Adma International School for the Summer School, in accordance with the terms, rules and regulations of the school.
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TEL: +961-9-740225/6/7 FAX: +961-1-740224       E-Mail: info@admais.edu.lb