Application For Registration

Please read the application carefully and fill in complete and accurate information
Name of the Child Sex : Male Female
Date of Birth  

Address with

Landline Telephone No

  Father Mother
Name
Educational Qualification

Occupation

Office / Shop
Mobile No.
Email  
Batch Morning Afternoon

Name of the Person/Guardian to be contacted in case of emergency with Telephone Number

Please furnish your child's Pediatrician's name and contact No.

Physical condition of the child.

Any disorder or challenges

Allergies if any - Yes No

(if yes)
* If the information provided is false or inaccurate your application is liable to be rejected. Please remember that Little Zebra also reserves the right to cancel admission already made and forfeilt all fees paid.