GS Application Form

Home>
GS Application Form

I. Students Personal Information
Academic Year (Choose One)*
Student Level (Choose One - Mandatory)*
- Preschool
- Primary
- Junior High
- Senior High
Grade Preschool
- Toddler
- Nursery
- K-1
- K-2
Grade Primary
- Grade 1
- Grade 2
- Grade 3
- Grade 4
- Grade 5
- Grade 6
Grade Junior High
- Grade 7
- Grade 8
- Grade 9
- Grade 10
Grade Senior High
- Grade 10
- Grade 11
- Grade 12
Student's Full Name*
Student Nick Name*
Place Of Birth*
Date of Birth (DD/MM/YY)*
Date Format: DD slash MM slash YYYY
Gender*
- Male
- Female
Religion*
- Catholic
- Protestan
- Moslem
- Hinduism
- Buddhism
Nationality*
- Indonesian
Passport Number (For Expatriate Students)
Previous School (Fill "0" if not school yet)*
Student Residing Address*
Student Home (Permanent) Address*
- Same as above
- Different from above
Student Home Permanent Address (If Different)
Student Phone / Mobile (if Any)
Student Email (if any)
Hobbies & Goals
II. Parent's Information - Father
Father Complete Name*
Place Of Birth*
Date of Birth (DD/MM/YY)*
Date Format: DD slash MM slash YYYY
Highest Educational Attainment*
- High School
- Diploma
- Bachelor's Degree
- Master's Degree
- Doctor's Degree
Religion*
- Catholic
- Protestan
- Moslem
- Hinduism
- Buddhism
Nationality*
- Indonesian
Passport Number (For expatriate student)
Occupation*
- Multinational Company Employee
- Private-Owned Company Employee
- State-Owned Company Employee
- Self-Employed
- Entrepreneur
Position*
- Director
- Manager
- Supervisor
- Staff
Company Name (Fill "0" if not working)*
Company Address (Fill "0" if not working)*
Monthly Income*
Father Home (Permanent) Address*
- Same as above
- Different from above
Father Current Address (If Different)
Phone / Mobile*
Email ((Fill "0" if father don't have email)*
Community Involvement
III. Parent's Information - Mother
Mother Complete Name*
Place Of Birth*
Date of Birth (DD/MM/YY)*
Date Format: DD slash MM slash YYYY
Highest Educational Attainment*
- High School
- Diploma
- Bachelor's Degree
- Master's Degree
- Doctor's Degree
Religion*
- Catholic
- Protestan
- Moslem
- Hinduism
- Buddhism
Nationality*
- Indonesian
Passport Number (for expatriate citizen)
Occupation*
- Multinational Company Employee
- Private-Owned Company Employee
- State-Owned Company Employee
- Self-Employed
- Entrepreneur
- Housewife
Position*
- Director
- Manager
- Supervisor
- Staff
- Housewife
Company Name (Fill "0" if not working)*
Company Address (Fill "0" if not working)*
Monthly Income*
Mother Home (Permanent) Address*
- Same as above
- Different from above
Mother Current Address (If Different)
Phone / Mobile*
Email (Fill "0" if don't have email )*
Community Involvement
IV. Guardian Information
Complete Name
Relation To Student
- Uncle / Aunt
- Grandparent
Place Of Birth
Date of Birth (DD/MM/YY)
Date Format: MM slash DD slash YYYY
Highest Educational Attainment
- High School
- Diploma
- Bachelor's Degree
- Master's Degree
- Doctor's Degree
Religion
- Catholic
- Protestan
- Moslem
- Hinduism
- Buddhism
Nationality
- Indonesian
Occupation
- Multinational Company Employee
- Private-Owned Company Employee
- State-Owned Company Employee
- Self-Employed
- Entrepreneur
Position
- Director
- Manager
- Supervisor
- Staff
Company Name
Company Address
Monthly Income
Guardian Current Address
- Same as student
- Different from student
Guardian Current Address (If Different)
Phone / Mobile
Email
V. Siblings
Sibling 1 (Name)
Sibling 1 (Grade/Age)
Sibling 1 (School Name)
Sibling 1 (Birth Date)
Date Format: DD slash MM slash YYYY
Sibling 2 (Name)
Sibling 2 (Grade/Age)
Sibling 2 (School Name)
Sibling 2 (Birth Date)
Date Format: DD slash MM slash YYYY
Sibling 3 (Name)
Sibling 3 (Grade/Age)
Sibling 3 (School Name)
Sibling 3 (Birth Date)
Date Format: DD slash MM slash YYYY
VI. Additional Information
Students lives with :*
- Parents
- Guardian
- SMIS Dormitory
Upload Copy of Birth Certificate
Upload Copy of Family Card
Upload Copy of Parent's valid ID Card (Father)
Upload Copy of Parent's valid ID Card (Mother)
Upload 3x4 Size Photograph of The Student
Upload Copy of Report Card
Upload Transfer Letter (for transfer student)
Upload Copy of Passport or Visa (non-Indonesian student)
Upload Copy of Passport or Visa Parent (non-Indonesian student)
Declaration & Agreement (please tick this option)*
- We declare that the information on this application is true and correct, and we understand that the school reserves the right to vary or reverse any regarding admission or enrollment made on the basis of incorrect information

Search

I. Students Personal Information

II. Parent's Information - Father

III. Parent's Information - Mother

IV. Guardian Information

V. Siblings

VI. Additional Information