Registration

Proposed year of entry* Proposed Entry Term:* Type of place (please tick)*

Details of Pupil

Legal Surname Legal Forenames Middle Name (s) Preferred Name Date of Birth Religion Nationality

Details of Parent/s

Mother/Legal Guardian

Title* Surname Forename and Initials Profession Nationality Permanent Address Postcode Contact telephone number Email

Father/Legal Guardian

Title* Surname Forename and Initials Profession Nationality Permanent Address Postcode Contact telephone number Email

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 named child. Their consent to the child attending the School will be required if an offer of a place is made.

Title* Surname Forename and Initials Permanent Address Postcode Contact telephone number Email

Details of present school (with dates of attendance)

Name Head’s Name Address Postcode Contact telephone number Email Dates of attendance

Existing Connections with the School

Please name any other members of the family attending the School: Please mention here the names of any other connection with the School e.g. a sibling, Old Worksopian/Old Ranbian: Please indicate how you first heard of the School* If 'Other' please give details here: The school has regular press features/columns/adverts etc. We would be grateful if you can state any that you have seen in newspapers, magazines or online: Please outline any of your child's artistic, dramatic, musical or sporting skills or experience (if applicable) Please give an outline of your child's other hobbies and interests (if applicable)

Under the school's Disablity Policy, and Special Educational Needs and Learning Difficulties Policy you have the opportunity to disclose:

any medical condition, health problem or allergy your child; and

any learning difficulty, disability, or special educational need of the child, as well as any behavioral, emotional and / or social difficulty of him/her.

Please note, all information received is treated in strict confidence.

REGISTRATION FEE

Early registration is recommended. Registrations will be considered in the order they are received. Offers of places are subject to availability and the admission requirements of the School at the time offers are made. A copy of the School's Terms and Conditions will be supplied on request.
Once this form has been submitted a member of the Admissions Team will be in contact to organise payment of your £100 registration fee.