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Form of Admission

    This application form should only be sent if your residence is outside of Trujillo or Perú.

Candidate information

Last name: :

First name:  

Brith Date: mm/dd/yy

Place of Birth: City.

Sex: Choice

Nationality:    Choice

Child´s primary language:  Choice

Pupil lives with:

Applying for :   Nursery    Primary   Secondary       (Choice)

Evaluation(s) could be programmed for aproximately:

 

Parents information

Father:

Last name: 

First name: 

Birth Date:  mm/dd/yy

Identification:  (DNI or passport) 

E-mail :  

Telephone / cellular:

Home address:

Employer:         

Profession:     

 

Mother:

Last name: 

First name: 

Birth Date:  mm/dd/yy

Identification:  (DNI or passport) 

E-mail :  

Telephone / cellular:

Home address:

Employer:        

Profession:     

 

Person responsible for student :  Father  -   Mother                                 (Choice)
                                                            Other specify:  
 

Comments:

                                                                                          

Av. América Sur 3701 - Trujillo - Perú
Casilla Postal 1310 - Tlf. (51) 44 280395 Fax .- (51) 44 284440
www.fleming.edu.pe  - informes@fleming.edu.pe

 

More information: Gladys Cuba   
 admisión@fleming.edu.pe   
 

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