Online Admission Form

Fill out the form below to apply for admission at Mpoma Parents School

Submitting your application...

Student Information

Surname *

Other Names *

Date of Birth *

Gender *

Nationality *

District of Origin

Religion

Birth Certificate Number

Student Photo (Passport Size)

Max file size: 2MB. Accepted formats: JPG, PNG

Academic Information

School Section *

Class Applying For *

Academic Term *

Academic Year *

Previous School (if any)

Last Class Completed

Parent/Guardian Information

Full Name *

Relationship to Student *

Email Address *

Phone Number *

Occupation

ID/Passport Number

Home Address *

Emergency Contact Name

Relationship

Emergency Phone

Emergency Email

Medical Information

Any Allergies? *

Yes

If Yes, please specify:

Any Medical Conditions? *

Yes

If Yes, please specify:

Doctor's Name

Doctor's Phone

Medical Insurance Details

Additional Information

How did you hear about Mpoma Parents School?

Additional Comments or Questions

I hereby declare that the information provided is true and accurate to the best of my knowledge. I agree to the Privacy Policy and Terms & Conditions of Mpoma Parents School. *

Application Submitted Successfully!

Thank you for applying to Mpoma Parents School. Your application has been received.

Our admissions team will contact you via email or phone within 5-7 business days.

For any urgent inquiries, please contact us at mpomaparentsschool@gmail.com or call +256 763 200 455.