Application Form for Admission
Please fill in as it appears on Passport and/or Birth Certificate/or National ID
Surname First Name Middle Name (if any)
Common/Nick Name:
Date of Birth [mm/dd/yy]:
Country of Birth: Nationality:
Passport No. _________________Expiry:________ National ID:______________________
Has the applicant previously attended /applied to CTS? Yes No
Brother(s) / Sister(s) at CTS? Brother(s) __________ Sister(s)_ ___________ applying with
Current/Recent School (Last school attended)
Name of School:
Last successful Grade attended Dates at this School:
From (mm/yy) To (mm/yy)
Address:
Tel: Fax:
Language of Instruction:
Has the applicant repeated or advanced any grade(s)? If yes, please explain
_____________________________________________________________________________________
Does the applicant have any special educational needs? If yes, please explain
______________________________________________________________________________
Main Language: Bengali English Other ____________________
Second Language: Bengali English Other ____________________
1
Previous School
Name of School:
Grade(s): Dates at this School: To (mm/yy)
From (mm/yy)
Address:
Tel: Fax:
Language of Instruction:
Did the applicant repeat or advance any grade(s)? If yes, please explain
_____________________________________________________________________________________
Did the applicant have any special educational needs? If yes, please explain if different than above
_____________________________________________________________________________________
_____________________________________________________________________________________
Main Language: Bengali English Other ____________________
Second Language: Bengali English Other ____________________
2
Proficiency level in English: (To the best of your knowledge)
Speaking: Please check the level which best describes your child
Level 1 Speaks fluently in the English language with ease of conversation on all topics
Level 2 Speaks moderately well in the English language with some but little difficulty on most
topics
Level 3 Speaks broken English with difficulty on some topics
Level 4 Speaks no English
Writing: Please check the level which best describes your child
Level 1 Writes fluently in the English language with ease of topic, excellent grammar,
punctuation and structure
Level 2 Writes moderately well in the English language with some grammatical and
punctuation error but good structure
Level 3 Writes in partial sentences with a great deal of difficulty with grammar, punctuation
and structure
Level 4 Is not able to write in the English language
Interests/Hobbies
Please give details of special interests and / or abilities which the applicant has in the areas of sports, arts or
pastimes (hobbies). List activities in which the applicant has been engaged.
______ _________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
______________________________________________________
Health
Please supply information regarding the applicant’s health and / or behaviour which may affect
his or her performance in the classroom, limits participation in physical education activities
and / or field trips. Information on allergies and / or medication(s) taken on a regular basis must be provided.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
______________________________________________________________________________________
3
Residential Address Information: All correspondence will be sent to the residential address unless
otherwise specified.
Address:
City: District: Postal Code
Tel: Fax:
Billing Address (if different than residence):
City: District: Postal Code
Tel: Fax:
Applicant is living with Both Parents Father Mother Guardian
Name:
1. _____________________________________________________________________________
2. _____________________________________________________________________________
Parents’ Information
Father’s Name
Nationality:
Company Name:
Position Held:
Tel: Fax:
Mobile: E-mail:
Mother’s Name
Nationality: Bangladeshi Occupation:
Company Name:
Position Held:
Tel: Fax:
Mobile: E-mail:
4
Parental Agreement
Students may not enrol in CTS unless one parent or legal guardian is in full-time residence in Bangladesh. I agree
that this applicant will be living with at least one parent or legal guardian while enrolled at CTS.
I give CTS permission to obtain records from the applicant’s current and previous school(s).
If this applicant is admitted, I understand that he/she must be covered under either Annual Capital Levy or a
School Debenture.
I certify that the information given in this application is full and complete to the best of my knowledge. I
understand that if I fail to provide accurate information for this application, CDNIS reserves the right to restrict
entry into, or withdraw a place from, the School.
Parent’s/Guardian’s name (Please print): ___________________________________________________
Signature: _________________________________________________
Date: ______________________________________
This application must be signed by the parent/guardian and submitted in original form, together with documents
listed below:
Copy of school reports for the previous and current school year. If the report cards are not issued in
English, please also provide a translated copy in English.
A transcript.
Copy of passport (Copy of Birth Certificate is required if the applicant does not carry a passport).
One photograph attached to this application.
Applications by fax or email will not be accepted. Please submit student application to:
Admissions Office
Canadian Trillinium School Ltd.
House # NW(C)- 7, Road # 62
Gulshan Model Town
Dhaka-1212, Bangladesh
Tel: +880-02-986-1068
Mobile: 0181-925-3796,0191-142-4444
Fax: +880-02-986-1068
E-mail: contact@cts.edu.bd
Web: www.cts.edu.bd
