Passport or Birth Certificate. (ONLY PDF file size below 5mb) *
PIO/OCI Card. (ONLY PDF file size below 5mb)
Upload a Photo (Passport or Headshot) of the applicant. (ONLY JPG file size below 5mb) *

Current School
Previous School 1
Previous School 2
Last two years progress reports (ONLY PDF file size below 5mb)
If you have answered Yes to any of the above, please include reports of tests of the therapy. (ONLY PDF file size below 5mb) *

Upload Vaccination Records (ONLY PDF file size below 5mb) *
Please note: A BCG vaccination is a vaccination against Tuberculosis. This is not given in North America but it is common in Africa, Asia and other parts of Europe and Great Britain
To be completed by the parents or guardians.
Medical History Yes/No If Yes, please explain
Cardiac Disorder*
Gastrointestinal Disorder*
Hearing Disorder*
Neuromuscular Disorder*
Orthopaedic Condition*
Respiratory Illness*
Skin Disorder*
Visual Disorder*
Seizure Disorder*
Chicken pox*
Scarlet fever*
Whooping cough*
Rheumatic fever*
Heart disease*
Others (Please specify)*
Participation for Sports Yes/No If Yes, please explain
Is the student diagnosed with Asthma and currently taking medication for it?*
Does the student Yes/No If Yes, please explain
Wear glasses or contact lenses?*
Have any known deformities?*
Tire quickly during exercise?*
Have frequent or severe headaches?*
Has the Student Yes/No If Yes, please explain
Ever fainted during or after exercise?*
Ever been dizzy during or after exercise?*
Ever had chest pain during or after exercise?*
Ever had racing of their heart or skipped heartbeats?*
Ever had high blood pressure or high cholesterol?*
Ever been told they had a heart murmur?*
Ever had a head injury or concussion?*
Ever been knocked out or become unconscious?*
Ever lost their memory?*
Ever had numbness or tingling in their arms, hands, legs or feet?*
Has any member of your family died before the age of 50?*
Has anyone in your family had a heart attack before the age of 50?*
I / We request that our child be registered as a prospective student.
I / We understand that the school may obtain, process and hold personal information about me / us, including sensitive information such as medical details, and I / We consent to this for the purposes of assessment, and, if a place is later offered, in order to promote and safeguard the welfare of the child.
I declare that all the information provided is correct and understand that false, inaccurate or misleading information could result in the student’s withdrawal from school.
Stonehill's parent organisation is Embassy Group, and we are proud to be an Embassy Group Education Initiative. Please indicate your permission for us to share your details with Embassy Group.

DATE: 19 Aug 2019 07:51 PM