Acceptance Abugiss

FORM A
ABURI GIRLS’ SENIOR HIGH SCHOOL

(PRESBYTERIAN)
B.E.C.E. Index No. …………………………
ADMISSION ACCEPTANCE FORM
I wish to accept the placement of my ward at Aburi Girls’ Senior High School, as DAY/BOARDER.
STUDENT PERSONAL RECORDS:-
1. Surname:……………………………….. First Name:………………………………………………

Other Names: ………………………………………………..…
2. Date of Birth: ………………………………….. Place of birth: …………………………. Age:……..
3. Nationality and how it was acquired :…………………………………………………………………..
4. Hometown:………………………………………………….Mother Tongue: …………………………
5. Religion:……………………………………………..Denomination:………………………………….
6. Last School attended:……………………………………………………………………………………
7. Date of completion:…………………………………………………………………………………..
8. Place of Residence:…………………………………………. Region:…………………………………
9. Father’s Name:…………………………………………………………………………………………..
10. Postal/Digital Address:………………………………………………… Region: ……………………..
11. Occupation: ……………………………......... Email:-……………….. ………………………………
12. Religion:………………………………………… Telephone No: …………………………………….
13. Alive Deceased
14. Mother’s name: ………………………………………………………………………………………….
15. Postal Address…………………………………………………….. Region………………………..….
16. Occupation: …………………………………… Email address: ………….. ………...………………..
17. Religion: ……………………………………….. Telephone Number: ……………………………….
18. Alive Deceased
19. Name of Guardian: (If different from Parents) ………………………………………………………..
20. Postal Address: ……………………………………………… Region:……………………………….
21. Occupation: ………………………………………….. Telephone No.: ………………………………
22. Relationship to student:…………………………E-mail:………………………………………………
SIGNATURE OF PARENT/GUARDIAN: ……………………………DATE: ………………….
1
FORM B

(PRESBYTERIAN)
MEDICAL DISCLOSURE FORM
Kindly provide information on your ward’s medical history to help the school give her the appropriate care
where necessary. The information provided will be handled confidentially.
BIO DATA
Name of Ward:………………………………………………………………………………………………
Age:………………………………………………… Date of Birth:…………………………………………
Nationality:…………………………………………. Religious Denomination:. ……………………………
Contact Address of Parent/Guardian: …………………………………………………………………………
…………………………………………………….. Tel. No. of Parent/Guardian…………………………….
PAST MEDICAL RECORDS

A. Has your ward ever suffered from or been advised that she has any of the underlisted medical
conditions? (Please indicate Yes or No and UNDERLINE the relevant condition).
Please Tick:
YES NO
Epilepsy, Convulsions or other fainting spells
Depression or other mental illness
Anaemia
Tuberculosis, Pneumonia, Bronchitis
Peptic Ulcer, Colitis
Diabetes Mellitus ‘Sugar in the urine’
Hepatitis
Asthma or allergy
High Blood Pressure, Low Blood Pressure
Dysmenorrhea (Painful menstruation)
Bed Wetting
Others, specify below in the space provided:
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
………………………………………………………………………………………………………….
2
B. i) Has your ward ever been admitted to a Hospital, Health Centre or Clinic?
Yes No
ii) Has your ward ever had surgery, Yes No:
If the answer to any of the questions above is ‘YES’, Please give details below:
DISEASE/INJURY/SURGERY DATE DURATION NAME & ADDRESS OF HOSPITAL
DECLARATION:
I, ………………………………………………….., parent/guardian of ……………………………………,
hereby declare that the information given above are true and that no pertinent aspects of her medical history
has been concealed.
……………………………………….. ………………………………………..
SIGNATURE DATE
3
FORM C

(PRESBYTERIAN)
LETTER OF UNDERTAKING AND DECLARATION OF INTENT
Having accepted admission for my ward/daughter,
I, .........................................................................................do hereby give the following undertaking.

(Name of parents/guardians)
That my ward and I agree to strictly abide by the school’s stand not to compromise the decision
of the Board on Private Examination – “Nov./Dec.” whiles in school.
………...........................................................
SIGNATURE OF PARENT/GUARDIAN
DATE: ...................................................
FORM C

(PRESBYTERIAN)
LETTER OF UNDERTAKING AND DECLARATION OF INTENT
Having accepted admission for my ward/daughter,
I, .........................................................................................do hereby give the following undertaking.

(Name of parents/guardians)
That my ward and I agree to strictly abide by the school’s stand not to compromise the decision
of the Board on Private Examination – “Nov./Dec.” whiles in school.
………...........................................................
SIGNATURE OF PARENT/GUARDIAN
DATE: ……….............................................
4
FORM D
(PRESBYTERIAN)
PARENTAL CONSENT ON OUTINGS
I have no objection to allowing my daughter: ……………………………………………..from going on

(Name of Student)
educational excursions/sporting activities, etc. organized by the school.
Date:-………………………………… Tel. (Office/Workplace):………………..
………………………………………..
(Name & Signature of Parent/Guardian)
CUT HERE AND KEEP INFORMATION BELOW
FORM E
Girls are only allowed to leave the school on excursions, Sporting Activities etc. planned by the school and
they do so under the supervision of assigned member(s) of staff.
Girls are not allowed to go home on instant requests or in response to telephone calls. They are also
not allowed home for weddings, religious and social functions, funeral of distant relations etc.
Girls should not refuse medical treatment from the School medical staff/KOM Presbyterian Hospital.

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FORM A

ABURI GIRLS’ SENIOR HIGH SCHOOL

B.E.C.E. Index No. …………………………

ADMISSION ACCEPTANCE FORM

STUDENT PERSONAL RECORDS:-

1. Surname:……………………………….. First Name:………………………………………………

SIGNATURE OF PARENT/GUARDIAN: ……………………………DATE: ………………….

ABURI GIRLS’ SENIOR HIGH SCHOOL

Age:………………………………………………… Date of Birth:…………………………………………

Nationality:…………………………………………. Religious Denomination:. ……………………………

Contact Address of Parent/Guardian: …………………………………………………………………………

…………………………………………………….. Tel. No. of Parent/Guardian…………………………….

PAST MEDICAL RECORDS

ii) Has your ward ever had surgery, Yes No:

DISEASE/INJURY/SURGERY DATE DURATION NAME & ADDRESS OF HOSPITAL

I, ………………………………………………….., parent/guardian of ……………………………………,

has been concealed.

ABURI GIRLS’ SENIOR HIGH SCHOOL

LETTER OF UNDERTAKING AND DECLARATION OF INTENT

Having accepted admission for my ward/daughter,

I, .........................................................................................do hereby give the following undertaking.

ABURI GIRLS’ SENIOR HIGH SCHOOL

LETTER OF UNDERTAKING AND DECLARATION OF INTENT

Having accepted admission for my ward/daughter,

I, .........................................................................................do hereby give the following undertaking.

PARENTAL CONSENT ON OUTINGS

I have no objection to allowing my daughter: ……………………………………………..from going on

educational excursions/sporting activities, etc. organized by the school.

Date:-………………………………… Tel. (Office/Workplace):………………..

CUT HERE AND KEEP INFORMATION BELOW

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