Application Portal | Providere Academy

Student Information — Personal Details

First Name *

Middle Name

Surname *

Date of Birth *

Gender

Nationality

Country of Birth

District

Village / Town

Home Language

Other Languages Spoken

National ID / Passport No.

Birth Certificate Number

Applying For

Grade / Stage Applying For *

Academic Year *

If your child is transferring from another school, you'll add those details under Academic Information in a later step.

Parent / Guardian 1

Relationship to Child *

Title

First Name *

Last Name *

Occupation

Employer

Mobile Number *

Alternative Number

Email Address *

Emergency Contact

Someone we can reach if a parent/guardian above is unavailable.

Full Name *

Relationship *

Phone Number *

Home Address

District *

Community / Village *

Street (if applicable)

Physical Address *

Postal Address

Medical Information

This information is treated with full confidentiality and used only to keep your child safe and supported.

Allergies

Medical Conditions

Disabilities / Special Educational Needs

Current Medication

Blood Group

Medical Aid (if applicable)

Family Doctor / Clinic

Doctor / Clinic Phone Number

Academic Information

Leave this section blank if your child has not attended school before.

Previous School

School Address

Last Grade Completed

Current Grade

Year Left Previous School

Languages Studied

Reason for Leaving Previous School

Has the learner repeated a grade?

Has the learner been suspended or expelled?

Additional Information

Religion

Siblings Attending the School

Extracurricular Interests

How did you hear about Providere Academy?

Message / Questions for Admissions

Documents to Upload

Upload clear photos or scans (PDF, JPG or PNG, max 5MB each). You can leave optional documents out and email them later to admissions@providereacademy.co.ls if needed.

Required

Certified Birth Certificate *

No file chosen

Passport-size Photograph *

No file chosen

Parent/Guardian National ID or Passport *

No file chosen

Proof of Residence *

No file chosen

Previous School Report / Report Card

No file chosen — leave blank if first time at school

Transfer Letter (if changing schools)

No file chosen

Immunisation / Vaccination Card *

No file chosen

Optional (if applicable)

Medical Report

No file chosen

Special Needs Assessment

No file chosen

Court Guardianship Documents

No file chosen

Scholarship / Bursary Letter

No file chosen

Review & Declaration

Parent / Guardian Full Name (Signature) *

Date *

Your application will be sent directly to our admissions team at admissions@providereacademy.co.ls. We aim to respond within 3 working days.

Application Received