Admission Form — Butterstone International Schools

Personal Data

Child's Name*

Sex*

Date of Birth*

State of Origin*

LGA*

Child's Home Address*

Home Phone*

Recent School Attended

Class Admission is Sought For*

1st Parent / Guardian

Full Name*

Occupation

Email Address

Work Phone

Cell Phone*

Office/Business Address

Home Address (if different from child)

2nd Parent / Guardian (If Any)

Full Name

Occupation

Email Address

Work Phone

Cell Phone

Office/Business Address

Home Address (if different from child)

Child lives with

Both ParentsMotherFatherOther:

Medical Health History

Does your child have a history of: (check all that apply)

Is your child on any medication? Please list medications and dosage

Has your child ever been hospitalized? When and for what?

Has your child had any serious accidents? Describe.

Allergies

Does your child have any allergies?

YesNoUnknown

List child's allergies

Do you know what the allergy is caused by?

Is there anything you would like to share about your child's health?

Family Doctor's Name

Family Doctor's Phone

Dentist's Name

Dentist's Phone

Document Uploads

Passport Photo of the Child*

Upload a clear passport photo of the child (JPEG, PNG or WEBP only)

Click to upload — JPEG, PNG or WEBP · max 5 MB

Photocopy of Last School Result

Upload scan or photo of child's most recent school report (optional)

Click to upload — JPEG, PNG, WEBP or PDF · max 5 MB

Birth Certificate*

Upload a copy of the child's birth certificate

Click to upload — JPEG, PNG, WEBP or PDF · max 5 MB

Kindly Pay Admission Form Fee Before Submitting

Kindly pay the admission form fee to Opay account 6423770887 — Butterstone Secondary School, then upload your bank teller below.

After payment, kindly upload your bank teller or screenshot as proof of payment

JPEG, PNG, WEBP or PDF · max 5 MB