Student Information

Full Name
  Preferred Name (if any)
  Date of Birth
  Student Gender MaleFemaleOther

Current Grade
Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12Post Matric   Applying for Grade
Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12Post Matric   Year of Entry
2025202620272028

Current School
  Academic Interests / Strengths
  Extracurricular Interests

Medical Information, eg. allergies / conditions if any
  Academic Information, eg. psychoeducational diagnoses
 

Parent(s) / Guardian(s) Information 1

Full Name
  Relationship to Student
  Phone Number

Email Address
  Residential Address
  Preferred Contact Method
EmailPhoneWhatsApp

Parent(s) / Guardian(s) Information 2

Full Name
  Relationship to Student
  Phone Number

Email Address
  Residential Address
  Preferred Contact Method
EmailPhoneWhatsApp

Supporting Documents - please upload the following?

Latest School Report
  Certified Colour Student ID or Birth Certificate

Certified Parent / Guardian ID's
  Any additional supporting documents (optional)

Additional Information

What draws you to Montgomery & Miller Academy?
  Any learning needs or support requirements?
  How did you learn about us?
WebsiteSocial MediaReferralEventOther

Online declaration that:

The information provided is accurate to the best of my knowledge. I provide consent that this information can be processed for application purposes.

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