Online Registration Form | BernHardt Secondary School and College

Applicant Information

Name ^{* required}

Middle Name

Last Name ^{* required}

Gender ^{* required}

DOB (BS)

DOB (AD)

Mobile number ^{* required}

Email for correspondence ^{* required}

Province ^{* required}

District ^{* required}

Ward

Father's Name ^{* required}

Father's Occupation

Father's Mobile No.

Mother's Name ^{* required}

Mother's Occupation

Mother's Mobile No.

Guardian's Name ^{* required}

Guardian's Occupation

Guardian's Mobile No.

School's Name ^{* required}

School Type ^{* required}

School District ^{* required}

School/Principal's Number

SEE Grade

SEE Send Up grade

SEE Send Up Grade sheet

Class Applying for ^{* required}

Stream ^{* required}

Stream Type ^{* required}

Applying as a ^{* required}

Yes No

Are you applying for Scholarship ^{* required}

Yes No

Are you using school bus? ^{* required}

Reasons for Scholarship

How did you know BernHardt?