Student Registration

First Name

Last Name

Username or E-mail

Gender

MaleFemale

Birth Date

Password

Confirm Password

Which Academic Year will the student join us in?

Proposed Date of Entry?

Has this student previously studied at Max Homes Schooling?

YesNo

Does the student have a sibling at Max Home Schooling?

YesNo

Student Nationality?

Students Country of Residence?

Phone Number

Mobile Number

Emergency Phone Number

Only fill in if you are not human