IDMANN Registration Form

User Registration

* Required field

Name *

Username *

Password *

Confirm Password *

Email Address *

Confirm Email Address *

Application Form

Parent/Guardian's Title (Select One) *

Mr. Mrs. Ms.

Parents' First Name *

Parents' Middle Name (optional)

Parents' Last Name *

Home Address I *

Home Address II (optional)

City *

State/Province *

Zip Code / Postcode (optional)

Country *

Parent's Primary Email Address *

Parent's Secondary Email Address (optional)

Mobile/Cell Phone Number I (Including Country Code) *

Mobile/Cell Phone Number II (Including Country Code) (optional)

YOUR Relationship To The Student Being Registered *

Mother Father Legal Guardian Sibling Aunt Uncle Grandparent Self Other

Emergency Contact (First Name) *

Emergency Contact (Last Name) *

Emergency Contact Phone Number *

Emergency Contact Email (optional)

Relationship Of The EMERGENCY CONTACT To The Student Being Registered *

Mother Father Legal Guardian Sibling Aunt Uncle Grandparent Other

Student's First Name *

Student's Middle Name (optional)

Student's Last Name *

Student's Date Of Birth *

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Is The Student Currently Being Home-Schooled? *

No Yes

Program(s) Of Interest - Select All That Apply *

Cooperative Parents' Alliance Private Tutor Program Global Summer Camp High Achievers' Camp Entrance Preparation Program International Language Program

If You Are Registering For EPP, Please Indicate The Specific Exam(s) Of Interest (optional)

If You Are Registering For ILP, Please Indicate The Specific Language(s) Of Interest (optional)

Which Of The Following Applies To You? *

I do NOT want to be a member of a cooperative alliance. I want to FORM a cooperative alliance. I ALREADY have a cooperative alliance I want to join. I NEED help joining a cooperative alliance.

If You Already Have A Cooperative Alliance You Want To Join, Kindly Enter The Details Below. (optional)

Desired Start Date (Click On The Button To Select) *

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If Your Child Has Special Needs, Please Describe Them Below. (optional)

Provide Any Additional Information You Deem Useful For The Application. (optional)

Are You Legally Authorized To Register This Child In This Program? *

No Yes

EOA Affiliate Code (optional)

Cancel

IDMANN Academy Student Registration Page

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