Holy Faith Convent Penal
Clarke/Lachoos Road, Penal, Trinidad W.I.
Phone/Fax:647-8834;Email:hfcp69@hotmail.com, hfcp@tstt.net.tt
Preregistration
New Form 6 Students




STUDENT INFORMATION
Student Surname
Student First Name
Student Middle Name
Form Class
Entry Date   
Birth Certificate #
Student Address
Student Contact # (HOME)
Student Contact # (Mobile)
Date of Birth   
Place Of Birth
Citizenship
Ethnicity
Religion
Name of previous school
Address of previous school
Hobbies
Achievements
MEDICAL/HEALTH INFORMATION
Immunization Record Received?
Date Immunization Record Received   
Allergies? (Specify below)
Medications? (Specify below)
Any special health problems? (Specify below)
Special Medical Information/History of Child
Remarks
IN CASE OF EMERGENCY NOTIFY
Name
Address
Relationship
Employment
Phone (home)
Phone (mobile)
Phone (work)
FAMILY DATA
Father's Name
Address
Phone (home)
Phone (mobile)
Phone (work)
Occupation
Business/Work Address
Father's Email Address
Mother's Name
Address
Phone (home)
Phone (mobile)
Phone (work)
Occupation
Business/Work Address
Mother's Email Address
Marital Status
*In the case of Divorce or Separation:
Is student subject to CUSTODY/SHARED PARENTING?
Agreement or Limiting order?

Please Specify


Copy of Order Submitted?
Guardian's Name
Guardian's Relation
Address
Contact # (Guardian)
Guardian's Occupation
Business/Work Address
Business/Work Phone
Guardian Email Address
Pupil lives with
Family Consists of Male Adults

Female Adults

Boys

Girls

Pupil's place in family
Parent Email Address
(to receive exam results - ONE email address only)
Name of Person Completing this online form
Please ensure that all information is correct and
the 'I'm not a robot' checkbox to the left is checked before submitting !