Kingdom Christian Academy

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Student Information

Please provide accurate personal details

First Name *

Middle Name

Last Name *

Gender *

Date of Birth

Nationality

Place of Birth

Religion

Class Applying For *

Grade Completed

Last School Attended

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Passport Photo

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Health Information

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Allergies

Disability / Impairment

Additional Notes

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Parent & Guardian Information

At least one parent/guardian contact is required

Mother's Details

Full Name

Phone Number

Address

Father's Details

Full Name

Phone Number

Address

Guardian (If Different From Parents)

Full Name

Phone Number

Address

By submitting, you confirm all information provided is accurate and truthful.

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Kingdom Christian Academy

Kingdom Christian Academy

Student Information

Passport Photo

Health Information

Parent & Guardian Information

Dr. Gayflor