Welcome to Good Samaritan!! Admission Form Fields marked with an * are required Child Information Child Information This section collects information about the child. Name * DOB (DD/MM/YYYY) * Age * The age as per March of this year is calculated. Gender * Male Female Programs Enrolled * Play Group Pre-KG Junior KG Senior KG Day Care Tuitions Address * Allergies if any Divider Parent Information Parent Information This section collects information about the parent. Father's Name * Phone Number * Occupation * Employer * Email address * Divider Mother's Name * Phone Number * Occupation * Employer * Email address * If you are a human seeing this field, please leave it empty.