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Rawai Park School Registration Form
Academic year 2022/2023
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Email
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Your email
Welcome to Rawai Park Language School. Please provide complete information to us.
Student's Details
Full Name
*
Your answer
Nationality
*
Your answer
Gender
*
Male
Female
Date of Birth
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MM
/
DD
/
YYYY
Place of Birth
*
Your answer
Father's language
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Your answer
Mother's language
*
Your answer
Language spoken at home
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Your answer
Address in Thailand
*
Your answer
Student's Previous Education
Previous School
*
Your answer
Class / Level
*
Your answer
Comments
Your answer
Parents' Contact Details
Father's full name
*
Your answer
Father's phone number
*
Your answer
Mother's full name
*
Your answer
Mother's phone number
*
Your answer
Email
*
Your answer
Parents' occupation and company's name
*
Your answer
Student Emergency Information Form
Contact Details of Private Insurance Company
Insurance company name
*
Your answer
Insurance company phone number
*
Your answer
Hospital that your insurance is linked to
*
Bangkok Hospital Phuket
Siriroj Hospital
Dibuk Hospital
Vachira Hospital
Mission Hospital Phuket
Chalong Hospital
In case of accident or illness, the school will contact parents as soon as possible. Please aid us in doing so by providing the following telephone numbers:
Priority contact number:
*
Your answer
Name and phone number of someone who is likely to be able to inform you quickly in case not reachable:
*
Your answer
Medical History
Does your child suffer any allergies?
*
No
Yes
Other:
If yes please indicate in details what type of allergy:
Your answer
Does your child have any dietary restrictions?
*
Yes
No
Other:
If yes please indicate in details:
Your answer
Is there any other medical condition that the school should be aware of?
*
No
Yes
If yes please indicate in details:
Your answer
Has your child ever received assistance for Special needs of any kind?
*
No
Yes
If yes please indicate in details:
Your answer
Any comments
Your answer
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