Maxwell Adventist Academy

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New Student Application
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Maxwell Adventist Academy

Private Bag Mbagathi 00503
Nairobi, Kenya
admin@maxwellsda.org                                    Date of Application:
Personal Information

Last Name/Family Name: Given Name(s): 

Date of Birth:    Age:     Male: Female:  

Language Spoken at Home:

Baptized? Yes: No:      Religious Affiliation/Denomination:
 
Address:

Email Address:
Home Phone:
Mobile Phone:


Passport Information

Passport Number: Date of Issue:
Valid Until: Place of Issue:
Passport Country: Place of Birth:
        
Valid Kenya Pupil Pass? Yes:  No:               Please bring 4 passport photos with you.


Family Information: Father (Guardian A)

  Name: Occupation:

Religion:   Employing Organization:    

 Work Address:                                


 Home Address:

Work Tel:   Email:   Mobile:

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Mother (Guardian B)

  Name: Occupation:

Religion:   Mother's Employing Organization:    

 Work Address:                                   


 Home Address:  

Work Tel:   Email:   Mobile:


Educational Information

Current Grade or Last Completed:    Grade Applying For:

List the names and addresses of all SECONDARY schools or CORRESPONDENCE schools you have attended. Please send a transcript of all secondary school work taken thus far or a transcriptof all primary school work taken thus far if applying for grade 9.
                   School                                  Address                     Grade Level           Dates
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Financial Information

If the applicant is eligible to receive tuition subsidy from either parental employer, what organization subsidizes you?


Additional Comments



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Private Bag Mbagathi • Nairobi, KY, 00503 •


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