| Surname ................................................. |
Proposed date
of enrolment ...................................... |
Forename/s ......................................................................................................... |
Date of birth ........................................... |
Nationality ......................................... |
Day or Boarding ..................................... |
Male/Female ..................................... |
School currently attended ................................................................................... |
Dates from ........................................... |
To ...................................................... |
Current Class or Form ......................................................................................... |
Any special circumstances affecting the application (e.g. siblings currently attending or applying to Dollar Academy) |
..............................................................................................................................
|
Are there any matters (special needs history, illness, medical condition) which might be of significance for the applicant’s school experience?
(It is helpful for the school to be aware of such matters; please provide details overleaf) YES/NO
|
Full Name of Parent/s
or Guardian/s ........................................
|
Occupation ........................................ |
Address ................................................................................................................
.............................................................................................................................. |
Telephone No/s: |
Email Addresses: |
Home: ...................................................... |
...........................................................
|
Work: ...................................................... |
........................................................... |
Mobile: .................................................... |
........................................................... |
Address for accounts, if different from that given above
..............................................................................................................................
..............................................................................................................................
|
If Parents or Guardians are resident abroad, the school requires, as a condition of acceptance, that a guardian in this country is named. Please give details below:
..............................................................................................................................
|
| ................................................................ |
Telephone No .................................... |
I hereby apply for admission to Dollar Academy on behalf of ...................................... and in the event of his/her enrolment, agree to conform to all regulations of the school. I understand that payment of the Registration Fee will not guarantee admission to the school.
|
(A Registration Fee of £20, payable to Dollar Academy and drawn on a UK cheque, or, in the case of those with accounts overseas, a sterling bank draft, should accompany this application.) |
A full term’s notice is required before the withdrawal of a pupil after the acceptance of the place. Otherwise the fee will be charged in lieu of such notice. |
Date ........................................................ |
Signed ................................................. |
For office use only |
|
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