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BAIS Application Form
(Preschool - Kindergarten)


Only current BAIS family names submitted with this application will be considered for the referral discount. Any name submitted after this application has been submitted will not qualify for discount.
BAIS desires to support all students in order to help them reach their full potential. However, in order to ensure that we can serve your children, please provide us with as much of the information below as possible.
Has your child ever been referred for psychological and/or behavioral testing?
Has your child ever participated in psychological and/or behavioral testing?
Does your child have any psychological diagnoses?


Names and birthdate of siblings
If your child is not going to be living with their parents, please complete this section for the Guardian Information.
Please provide a contact in Bandung or Kota Baru Parahyangan that can be contacted if there is an emergency and the parents/guardian cannot be reached.


If you check "Yes" to any of the following questions, please tell us more information about it.
Is your child receiving continuing medical care?
Is your child taking any medications regularly?
Is your child using any medical devices?
Is your child subject to asthma?
Is your child subject to epilepsy?
Does your child have diabetes?
Does your child have any hearing impairment?
Does your child have any visual impairment?
Does your child wear eye glasses/contact lenses?
Is your child allergic to any medications?
Is your child allergic to any foods?
Does your child have any other allergies?


1. Students are not to bring any medication to school unless it is absolutely necessary.
2. If a student must bring medication to school, please ensure it comes in its original container with original labelling.
3. The parent must send precise instructions written in English indicating the time of administration, dosage, name of the medication, and the reason the child must take the medication. The parental note must also include the name and phone number of the prescribing doctor in the case of prescription medicine. If the instructions are not clear to the administering BAIS faculty or staff member, the child will not be allowed to take the medication.
4. All medication must be relinquished to the school medical personnel upon arrival at school. This medication must be stored in the clinic in a secure area that is not accessible to students. Exceptions to this rule must be approved by the administration. This would only be allowed in cases where the student must maintain the medication on their person due to possible medical emergencies, ie. students with asthma problems.
5. Students may not, at any time, give or sell another student medication.
6. The school medical personnel is responsible to administer the student's medication at the appropriate time. In cases where the school medical personnel is not available, the administration will administer the medication in their place.
If the parents/guardians are not available or contactable, I authorize BAIS to arrange for emergency medical treatment. I hereby authorize the school to give the following simple medications, at the recommended dosage, to my child in the event of essential need:
Panadol or Ibuprofen in case of pain or fever
Antihistamine in case of allergic reactions
Lotion in case of skin reactions
Throat lozenges in case of sore throat
Antacid in case of upset stomach
Cold or Flu decongestants/cough medication
Inhaler for asthma flare-up