RAJAGIRI International School LLC POBOX: 62012,

ASSESSMENT FORM 2015 - 2016
RAJAGIRI International School LLC
POBOX: 62012, Al-Warqaa 1, Dubai, UAE.
Email: [email protected], Web: www.risdubai.org
T: 04-2800691, F: 04-2800692
Please bring along all the required documents mentioned on the website
Admission no:……….……………………...
Date:….…...….………..
Name of the child:…………..…………………………………………………………………......
Date of Birth:………………………………………………………………………………………
Grade to which admission is sought:…………..…………………………………………………
Siblings in RIS : ………….……………………………………………………………………….
Grade & Section of siblings: …………………………………….………………………………
Name & address of parents:……………….……………………………………………………….
…………………………………………………………………………..……………………….....
Phone numbers:…………………………….………………………………………………………
Email :……………………………………………………………………………………………...
Assessment Fees: DHS 50
FOR OFFICE USE ONLY
REGISTRAR:………………………………………………………………………….…………..
CLINIC:…………………………………………………………………………………………..
COUNSELLOR:……………………………………………………………………………….......
.........................................................................................................................................................
……………………………………………………………………………………………………..
SUPERVISOR:……………………………………………………………………………………
……………………………………………………………………………………………………..
…………………………………………………………………………………………………….
PRINCIPAL:………………………………………………………………………………………
ACCOUNTS:………………………………………………………………………………………
Page 1
REGISTRATION FORM 1
RAJAGIRI International School LLC
POBOX: 62012, Al-Warqaa 1, Dubai, UAE.
Email: [email protected], Web: www.risdubai.org
T: 04-2800691, F: 04-2800692
Admission to Grade: ……………………….
PHOTOGRAPH
Academic Year:………….………………….
Date of Admission: …………………………
Admission No: …..………………………….
Name of the child (as in the passport)……………………………………………………………...
Gender:
Male
Female
Religion:………………………………………
Second language:
Hindi
French
Malayalam
Date of Birth:…………………………………
Place of Birth (city / state):………………...
Country:………………………………………
Nationality:………………………………...
Passport Number:…………………………….
Issued at:…………………………………..
Date of Issue:………………………………….
Date of Expiry:……………………………...
Visa Number:………………………Date of Issue:……………….Date of Expiry:…………………….
Emirates ID No……………………….……Date of Issue:…………….Date of Expiry:……………….
Parents / Guardian’s Name:………………………………………………………………………………
Mobile No:……………………………………
Email:………………………………………..
LOCAL ADDRESS
P.O.B
ox:………………………………………
Emirate:……………………………………...
Residential Address (area):……………………………………………………………………………….
Telephone Numbers: Residence:………………....Office:……………………Mob:…………..……….
Page 2
REGISTRATION FORM 2
DETAILS OF CHILD’S PERFORMANCE
Name of the school last attended:………………………………………………………………………...
Grade:……………………………………
Syllabus followed:
ISC
CBSE
Special extra-curricular of the child:
Second language at school:………………………….
O-LEVEL
Sports
Others (Please specify):……………………
Music
Drama
Art
Has your child participated in any ‘Inter-school / Inter- House’ activities?
Elocution
Dance
Yes
No
If yes, please give the details:…………………………………………………………………………….
Does your child need special medical care?
Yes
No
If yes, please give the details:…………………………………………………………………………….
Does your child have any learning disability?
Yes
No
If yes, please give the details:…………………………………………………………………………….
1. Duly attested TRANSFER CERTIFICATE will be submitted by me on or before ……………
2. ………………………………… will be submitted by me on or before………………………….
3. ………………………………… will be submitted by me on or before………………………….
4. ………………………………… will be submitted by me on or before………………………….
I …………………………………………….. Father / Guardian of ……………..………………………
do declare and verify that the above details given by me are correct. If found incorrect, registration
may be rejected.
 I fully understand that the school on accepting the registration of the son / daughter is not in anyway
bound to grant admission, as the admission is purely based on the condition mentioned above.
 I have fully understood the rules and regulations of the school and accept my responsibility to see that my
son / daughter shall unquestionably abide by the decision of the Principal / Management and render all
co-operation to the school.
 I undertake that the school will not be HELD RESPONSIBLE for the admission of my son / daughter if
cancelled by the concerned Ministry, and I shall not claim any refund of fees paid by me whatsoever.
At registration one month tuition + registration + admission + activity fees must be paid. (non refundable).
School fees are paid in 10 PDC cheques.
If no PDC cheques, one extra month fees must be collected; it will be adjusted on the last month fees
of school year.
If the monthly fees is not received during the month, a 3 time warning will be forwarded with a gap of 3
days per warning. There after the student will be suspended as per KHDA regulations.
Would you like to have co-education in RIS from Grade 5 onwards?
Parent / Guardian Signature :…………………………….
YES
NO
Date:…………………………
Page 3
REGISTRATION FORM 3
RAJAGIRI International School LLC
POBOX: 62012, Al-Warqaa 1, Dubai, UAE.
Email: [email protected], Web: www.risdubai.org
T: 04-2800691, F: 04-2800692
STUDENT DETAILS:
Name of student: ………………………………………………………………………………….
Grade: ………… Section: ………….. Date of admission (to
Nationality:
………………………….
Religion:
be filled by office):
…..…………....
..…………………………………………
Second language: ……………………
PARENT’S INFORMATION
FATHER
Name(as in passport) ………………………
Nationality:………………………………..
Occupation : …………………………….…
Employer: ………………………….…….
Mobile No: …………………………………
Office Tel No: ……………………………
Email:
……….……………………………..
PO
Box:
………………………….………
MOTHER
Name(as in passport) : ………………………
Nationality: ………………………………
Occupation : …………………………………
Employer: ………………………….…….
Mobile No: …………………………………
Office Tel No: ..………………….………
Email: ………………………………….……
PO Box: ………………………….…..…..
Residence Address: …………………………………………………………………………….
Emirate: ………………………………………
Area (for Dubai Residents):……………….
Residence Tel No:…………………………….
Name & Address of local relative / Friend (to contact in case of emergency) :
Name:…………………………………………
Relationship to Child: ……………………..
Mobile No1: …………………………………
Mobile No2: …………………….…………
TRANSPORTATION DETAILS: (to be filled up after acceptance)
Pick-up point: ………………………………… Pick-up Time: …………………….……….
Drop-off point: ………………………………
Drop-off Time: …………………………….
…………………………………
Driver: ……………………………………..
Bus No:
Nanny: ………………………………………...
Page 4
TRANSPORT FORM
RAJAGIRI International School LLC
POBOX: 62012, Al-Warqaa 1, Dubai, UAE.
Email: [email protected], Web: www.risdubai.org
T: 04-2800691, F: 04-2800692
My Son / Daughter ………………………………….…………of Grade………………………..
Section …………………………………………………..… will be availing the following facility:
Transport
Yes
No
(If yes, kindly fill the following)
Pick-up point:…………………………………………………………………………......................
…………………………………………………………………………………………………….....
Drop off Point: ………………………………………………………………………………………
………………………………………………………………………………………………………
Landmark:…………………………………………………………………………………………...
……………………………………………………………………………………………………….
Telephone Numbers: Residence:……..………. Office :……………….. Mobile:…………………
Any other Instruction:……………………………………………………………………………….
……………………………………………………………………………………………………….
Parent’s
Signature:…………………………..
Accountant’s Signature:……………………..
Date:………………...……………….
Date:…………………………………
FOR OFFICE USE ONLY
Transport (w. e. f):……………………………
Route:…………………………….…
Bus Number:……………………………….....
Name of the Driver:……………………..……
Admin Officer’s Signature: ……………… …..
Bus
No.
:……………………………………….
Driver:……………………………….
Route:………………………………………………………………………………………………..
Pick-up point:………………………………………………………………………………………..
Transport Supervisor’s Signature:…………………………………………………………………...
Page 5
RAJAGIRI International School LLC
POBOX: 62012, Al-Warqaa 1, Dubai, UAE.
Email: [email protected], Web: www.risdubai.org
T: 04-2800691, F: 04-2800692
NAME OF THE CHILD: …………………………………………………..... DATE: ……………………………
DATE OF BIRTH: …………………………………………………………… CLASS: …………………………..
INSTRUCTIONS: kindly mark “√” to the following statements with reference to your child
SLNO
GROSS MOTOR
1
Climbs well
2
Walks down stairs alone, placing both feet on each step
3
Swings leg to kick ball
4
Runs easily
5
6
Bends over easily without falling
Walks up stairs alternating feet with support
FINE MOTOR
2
Makes vertical, horizontal, circular strokes with pencil or
crayon.(scribbles)
Turns book pages one at a time
3
4
Holds a pencil in writing position
Button and unbutton easily
5
Turns rotating handles (door knob)
1
LANGUAGE
1
2
Uses pronouns (I, you, me, we, they)
Recognizes and identifies almost all common objects and pictures
3
Can say name and gender
4
Uses words to communicate wants and needs
5
Knows simple rhymes and songs
6
7
Strangers can understand most of words
Communicate effectively with age adequate vocabulary
8
Answers to simple questions
COGNITIVE
1
Matches an object to a picture in a book
2
Plays make-believe with dolls, animals, and people
3
Waits for his turn
4
Sorts similar looking objects
5
Listens to stories
6
Knows several or any body parts
7
Understands concept of “two “and “one”
PERFECTLY
SLIGHTLY
DIFFICULT
DIFFICULT
RAJAGIRI International School LLC
POBOX: 62012, Al-Warqaa 1, Dubai, UAE.
Email: [email protected], Web: www.risdubai.org
T: 04-2800691, F: 04-2800692
SLNO
1
2
3
4
5
6
SOCIAL/EMOTIONAL
Interacts with peers comfortably
Expresses needs or thoughts clearly
Expresses a wide range of emotions
Engages in cooperative play
Begins to follow simple rules
Shows affection to whom they like
PERFECTLY
SLIGHTLY
DIFFICULT
DIFFICULT