Online Admission Form

Student Type * New Student Old Student

LRN No.

Grade Level *

First Name *

Middle Name

Last Name *

Suffix

Gender *

Date of Birth *

Place Of Birth

Mobile Number *

Email *

Upload Photo
Photo must be 2x2 or 1x1 in size in plain white background.Photo must be taken not more than 6 months prior to uploading.

Sibling Details

Sibling Name

Sibling Grade

Sibling Relationship

Discount and Promos

Discount and PromosKindly Check the Possible Discounts and Promos that are applicable to the student:

Early Bird Discount
Siblings Discount
Referral Discount
None

Parent Guardian Detail

Father Name

Father Phone *

Father Occupation

Mother Name

Mother Phone *

Mother Occupation

Mother's Maiden Name *

If Guardian Is * Father Mother Other

Kindly upload the requirments for enrollment
a. PSA Birth Certificate
b. SF9/Report Card

1. Upload Document
PSA Birth Certificate

2. Upload Document
SF9/Report Card

Guardian Name *

Guardian Relation

Guardian Phone *

Guardian Occupation

Guardian Email *

Guardian Address *

Social Media Links

Facebook URL

Twitter URL

Linkedin URL

Instagram URL

History *

School Name *	Grade attended *	Year Attended *	School Address *	#

Enrollment Contract *

Enrollment Contract

In consideration of my child admission to School, I hereby promise and pledge to abide by and comply with the rules and regulations of Brilliant Juninors Academy,

I hereby promise to pay on demand the full amount of my Enrollment fees and other fees as set by the school even if my child should stop studying or if my child transfers to another school.

I am fully aware that this enrollment contract is considered an expression of willingness to abide by all the rules and regulations of the school.

I further certify that all my statements herein are true and correct.

I understand and agree that clicking the " I agree to the terms and conditions" button affirms that I have read and agreed to the terms and conditions of the enrolment contract.

I agree to the terms and agreement.

Class Title *

Class Date *

Class Duration (Minutes) *

Role *

Staff *

Grade Level *

Section *

Host Video * Enable Disabled

Client Video * Enable Disabled

Description