Learner Personal Profile
PAGE 02 — LEARNER IDENTITY
Medical History & Emergency Protocols
Emergency Medical Consent
I, the undersigned, authorize Hope Garden Private School to secure emergency treatment for my child at the nearest medical facility if I am unreachable. I acknowledge that all costs incurred will be for the account of the parent/guardian.
Guardian Signature & Date
PAGE 04 — MEDICAL & SAFETY
Guardian Profile 01 (Primary Contact)
PAGE 05 — GUARDIAN 01
Guardian Profile 02 & Financial Responsibility
Person Responsible for Account (The Payer)
Institutional Banking Information
Bank Windhoek
Hope Garden Preschool
8051605774
Okakarara
Standard Bank
Hope Garden Preschool
60007072030
Otjiwarongo
FNB Namibia
Hope Garden Preschool
64284377677
Okakarara
OFFICIAL OFFICE USE ONLY — EXECUTIVE VERIFICATION
Date Received: _____________________
Receipt No: _____________________
Admission Status: [ ] APPROVED [ ] REGRET
Principal Signature & Approval (Mrs. Tendai Aib)
Institutional Seal
PAGE 06 — INSTITUTIONAL FINALIZATION