Student Information Update
Registration Information
School Name *
For Intake Year *
For Year/Level *
Preferred Session*
Student Information
Student Name*
Citizen
MyKID No / Passport No* (No Space and Dash '-')
Birth Cert. No
Birth Place* Others
Birth Date*
Gender/Race/Religion*
Tel. Mobile* (Parent) (No Space and Dash '-')
Email (Parent) Eg. mel@yahoo.com
Tel. Home
Address (Line 1)*
Address (Line 2)
City*
Postcode* Others
Untitled Document
Guardian / Father Information
Name*
IC No / Passport*
Relation*
Occupation
Salary* (RM)
Education
Employer
Address
Tel. Mobile (No Space and Dash '-')
Tel. Home
Tel. Office Fax:
Email Eg. mel@yahoo.com
Mother Information
Name*
IC No / Passport*
Relation*
Occupation
Salary* (RM)
Education
Employer
Address
Tel. Mobile (No Space and Dash '-')
Tel. Home
Tel. Office Fax :
Email Eg. mel@yahoo.com
For Emergency Contact (Beside Parent)
 Name*
 Relation*
 Tel. Mobile* (No Space and Dash '-')
 Tel. Home
 Tel. Office
 Fax
 Email Eg. mel@yahoo.com
Illness/Alergic

 Others (Specify) :  


I, here with agreed that all information given is correct. Genius Aulad has the rights to reject without prior notice. 
I hereby agree to put my child under the care of above center in the duration and vicinity of the preschool session. I understand that while the center is trying to maintain its best care of the child, the company should not be held responsible for any ailments and accident within time frame of the session. Thank You.