Student Registration

BENCHMARK EVENING SCHOOL

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School Year

Registration Date

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Name of Student

Gender

Phone/Mobile

Date Of Birth (DOB)

Residence

Name of Parent

Contact of Parent

Certificate Obtained

Year you obtained the certificate?

How did you know about Benchmark?

You are applying to be admitted into class?

Number of Subjects Chosen

Are you a returning student?

Yes

I promise to respect all admission conditions and school regulations without which I shall be subject to any decisions of the school.

I shall pay a non-refundable registration fee of 1,000 FCFA.