Your child

Forename*

Middle Name/s

Surname*

Date of Birth* (dd/mm/yyyy)

Nationality

United Kingdom Border Agency - Confirmation of Nationality*

Please specify Nationality here*

School Place

Proposed Year Group*

Proposed Term of Entry*

Proposed Year of Entry*

Have you registered your child's name at any other school(s) and if so, which?

Current School*

Signatory 1

Title*

Forename*

Surname*

Relationship to Applicant*

Street Address*

Address 2

Town/City*

County*

Post Code*

Country

Telephone*

Telephone

Email*

Occupation*

Signatory 2

Title

Forename

Surname

Relationship to Applicant

Street Address

Address 2

Town/City

County

Post Code

Country

Telephone

Email

Occupation

Where signatories have different addresses, please state which is the applicant's main residence*

Signatory 1 Residence Signatory 2 Residence

Other people with parental responsibility

Please provide the name(s) and current address(es) of any other person with parental responsibility (i.e. legal responsibility) for the above names child. This may be a legal guardian or step parent and their consent to the child attending the School will be required if an offer of a place is made.

Title

Forename

Surname

Relationship to Applicant

Street Address

Address 2

Town/City

County

Post Code

Country

If someone other than the first and second signatories is to pay the School fees for your child please provide below their full name and address and their relationship to your child.

Title

Forename

Surname

Relationship to Applicant

Street Address

Address 2

Town/City

County

Post Code

Country

Further Details

Do you have any other connection with the school?*

This includes, but is not limited to, family members or close relations: already a student, registered for entry, or working for/at the school.

Yes No

Other connection with the school*

Please provide names and the nature of the connection with the school

Does the Applicant have any medical conditions (incl. allergies), Disabilities, or Learning Difficulties?*

Yes No

Details of any medical condition (including allergies), disabilities, or learning difficulties of the applicant:*

I confirm that all details above are accurate and correct*

Ticking this box equates to your signature and agreement to pay the £100 registration fee

Charge: 0.00