Admission Application

(*) - Represents required fields

Application Details

Pupil Personal Details

Title

Forename *

Preferred Forename

Middle Name

Surname *

Preferred Surname

Date of Birth (Format YYYY-MM-DD) *

Gender *
Female
Male

Proposed Calendar Year of Entry *

Proposed Season of Entry *

Proposed Year Group *

Pupil Basic Details

Ethnicity

- (1) Language *

Religion *

National Identity

Nationality *


- (1) SEN History *

SEN Status *

Start Date (Format YYYY-MM-DD)
* Please enter your child SEN status start date. IMPORTANT: If your child does not have special educational needs please enter today's date instead.

Address and Contact Details

Pupil Address Details

House Name

House Number

Street Name

District

Town

County

Postcode

Country

Contact Details

Home Telephone

Mobile Telephone

Email Address

Notes

Medical Details

Medical Details

Medical Notes

Medical Conditions

Carer Contact Details

- (1) Carer Information *

Carer Details

Title

Forename

Surname

Gender
Male Female

Relationship to Pupil

I am responsible for this pupil


Carer Address Details

Same address as pupil

House Name

House Number

Street Name

District

Town

County

Postcode

Country

Carer Contact Details

* Please enter at least 1 contact telephone number

Home Telephone

Work Telephone

Mobile Telephone

* Please enter at least 1 email address

Home Email Address

Work Email Address

Pupil School History

Current School Details

School Name *

Start Date (Format YYYY-MM-DD)

Leaving Date (Format YYYY-MM-DD)

- (1) Previous School Details

School Name

Start Date (Format YYYY-MM-DD)

End Date (Format YYYY-MM-DD)


On acceptance I understand a non-refundable cheque/postal order of £25.00 (For entrance at Year 7) and £40.00 (For entrance for other years than Year 7) for the Entrance Examination fee - please contact the Admissions Officer on 0161 226 3323.