Online Admission

C-Rose Academy

#15, New Jerusalem, Road 6, Off Pipe Line, Rumukwurusi, Port Harcourt.

+2348169950123

info@c-roseacademy.com

Basic Information:

Name *

Birth Date *

Gender *

Blood Group

Religion

Caste

Email *

Phone

National ID

Health Condition

Student Photo

Image file format: .jpg, .jpeg, .png or .gif

Academic Information:

Student Type

Class *

Group

Second Language

Father Information:

Father Name

Father Phone

Father Education

Father Profession

Father Designation

Mother Information:

Mother Name

Mother Phone

Mother Education

Mother Profession

Mother Designation

Guardian Information:

Is Guardian?*

Phone*

Relation With Guardian

Name*

Email*

National ID

Profession

Religion

Other Info

Present Address

Permanent Address

Address Information: Same as Guardian Address

Present Address

Permanent Address

Previous School Information:

Previous School

Previous Class

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