Pickup Card Request Form – Shrewsbury International School Phnom Penh

Pick up card request form

Dear Parent,

Please kindly complete the following form to request a pick-up card for your child. Once submitted, the Admissions Team will notify you when the card is ready for collection.

Parent Full Name

Student Full Name

Student's Year GroupPre-Nursery (Half-Day)Pre-NurseryNursery (Half-Day)ReceptionYear 1Year 2Year 3Year 4Year 5Year 6

Full Name of Pick up person in charge

Relationship with the student (eg. aunt, uncle, grandmother….)

Contact number of Email address of the pick up person in charge

Please upload student photo

No file chosen

Picture of the person in charge of pick-up

No file chosen

ID Card / Passport of the person in charge of pick-up

No file chosen

Would you like to authorize additional individuals to pick up your child/children?YesNo

Pickup Person 02

Full Name of Pick up person in charge

Relationship with the student (eg. aunt, uncle, grandmother….)

Contact number of Email address of the pick up person in charge

Picture of the person in charge of pick-up

No file chosen

ID Card / Passport of the person in charge of pick-up.

No file chosen

Consent *

By completing and submitting this form, I hereby request that the school issue a pick-up card for the individuals named above. This person(s) will be authorized to collect my child/children from school effective immediately upon submission of the completed and signed form.

In the event that the authorized individual is to be removed from the pick-up list, I will notify the school at my earliest convenience.