Immersion Programme Registration Form

Name

This field is for validation purposes and should be left unchanged.

Requested Immersion Programme Dates

From*

To*

Child Information

Please complete this form in a much detail as possible. We need this information to be able to process your application for a place for your child. Information which in mandatory for you to provide is indicated by a *. If you do not complete the mandatory sections in full this may jeopardise or delay.

Child's Name*

First Name Last Name

Child's Date of Birth*

Child's Current School Year*

Child's Gender*

Child's Current School Name*

Child's Current School Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Child's Passport/Birth Certificate (Upload)*

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB, Max. files: 2.

Child's Passport Number*

Child's Passport Expiry Date*

Parent/Guardian Information

Parent 1 Relationship to Child*

Parent 1 Title*

Parent 1 Name*

First Name Last Name

Parent 1 Home Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Home Telephone Number*

Mobile Telephone Number*

Email*

Enter Email Confirm Email

Add a second parent?*

Yes

No

Parent 2 Relationship to Child*

Parent 2 Title*

Parent 2 Name*

First Name Last Name

Parent 2 Home Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Home Telephone Number*

Mobile Telephone Number*

Email*

Enter Email Confirm Email

Agent Information

If you are an education agent applying on behalf of the family, please select ‘yes’ below.

Are you an Educational Agent?*

Yes

No

Agent Name*

First Name Last Name

Agent Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Agent Home Telephone Number*

Agent Mobile Telephone Number*

Agent Email*

Enter Email Confirm Email

UK Guardian Requirement

All international students not travelling as part of an organised group with an accompanying adult are required to have a UK-based guardian for the duration of the Immersion Programme.

Will the child be travelling as part of an organised group with an accompanying adult?*

Yes

No

Guardian Name*

First Name Last Name

Guardian Address*

This address must be within the UK.

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Guardian Home Telephone Number*

Guardian Mobile Telephone Number*

Guardian Email*

Enter Email Confirm Email

If not a Guardianship Agent, please confirm relationship to the pupil

Further Child Information

All information received in this form will be treated in confidence.

Child's English Level

Please upload any documents, such as school reports, detailing your child’s English level.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 20 MB, Max. files: 5.

Additional Needs*

Does your child have any special educational learning needs, medical conditions, health problems or allergies?

Yes

No

Additional Needs Disclosure

Please disclose any special educational learning needs, medical conditions, health problems or allergies. It will help us plan for your child’s arrival, if you can let us know of any: Learning difficulty; Special Educational Need; Disability; Behavioural, emotional and/or social difficulty. The information provided will enable the School to consider any adjustments that it may need to make to assist your child to participate in the School’s admissions procedure or when they enter the School. Please provide us with as much detail as possible. Where possible, please provide any relevant documentation such as medical reports, assessments etc. Prior to the commencement of the admissions process, we will contact you about any special arrangements your child may require.

Documentation (Upload)

Please upload any documentation relevant to your child’s additional needs.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 30 MB, Max. files: 10.

Terms and Conditions

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.

Parent 1 Electronic Signature*

Your name in block capitals.

Parent 2 Electronic Signature

Your name in block capitals.

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