JiMSchool Foundation records Warsaw |.

Address of residence (for correspondence) - if different from the above:

2. data of parents/legal guardians:

3. application data:

The candidate is applying for admission to the institution:

JiM Foundation Preschools

JiM Foundation Primary School

JiM Foundation's School Adapted to Work

I have a statement of special education needs:

Yes

Not

The ruling was issued due to:

Autism/Asperger's syndrome

Intellectual disability of mild degree

Intellectual disability of moderate or severe degree

Intellectual disability of a profound degree

Disabilities coupled other

Other disabilities

I am in the process of diagnosis at the Psychological and Pedagogical Clinic:

Yes

Not

Whether the candidate has an opinion on early development support (WWR)

Yes

Not

During

If YES, the opinion will be attached to this application.

Is the candidate a graduate of one of the JiM Foundation's educational institutions?

Yes

Not

Which JIM Foundation educational institution is the candidate a graduate of?

The peripheral school of the child due to the place of registration/residence is:

*Applies to candidates who apply for admission to Schools, after starting their education in another institution
Up to now, the candidate has attended a school (provide school number, address and telephone number):

Please write from where you have information about the activities of the JiM Foundation.

I declare that the above-mentioned data are in accordance with the facts.

School enrollment

Fill out the form

1. candidate data

2. data of parents/legal guardians:

3. application data: