Portal Reg: Parents

YOUR SURNAME:
YOUR NAME:
PARENTAL STATUS:	MOTHER FATHER
BIRTH DATE:	JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960
HOME ADDRESS:
OFFICE ADDRESS:
EMAIL:
CONTACT NUMBER(HOME USE):
CONTACT NUMBER(OFFICE USE):
ACCESS PIN:
CHILD'S ADMISSION NUMBER (the one you got in the Alert Email when your child paid fees):
CHOOSE A USERNAME:
CHOOSE A PASSWORD: