APPLICATION FORM BOARDER PREP-IB AND IB ABOUT THE STUDENT This is an application for boarding students starting
Prep-IB
IB
with start in August
Full name: Address: Postal code and city:
CPR no.:
County:
Country:
Please indicate the student’s official adress.
has a Danish passport
does not have a Danish passport but is an EU citizen
other:
GUARDIAN (MOTHER/FATHER) Title:
CPR no.:
Name: Address: Postal code, city and country: Private phone:
E-mail:
Cell phone:
Work phone:
CO-GUARDIAN (MOTHER/FATHER) Title:
CPR no.:
Name: Address: Postal code, city and country: Private phone:
E-mail:
Cell phone:
Work phone:
We use your e-mail adresses to give you access to the school’s parent intra. If you change your e-mail, please let us know. If the billing adress is not the same as the guardian’s, please fill in the information on page 5.
Name of custodial parent: At the annual elections for our Parent Representative Council only custodial parents have the right to vote. If one parent has sole custody, please enter his or her name above.
APPLICATION FORM FOR PREP-IB AND IB
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APPLICATION FORM BOARDER PREP-IB AND IB MOTIVATION FOR APPLYING A short statement explaining why the applicant is applying to Herlufsholm:
PREVIOUS SCHOOLING Year and grade level
Name of school
Language of instruction
STUDENTS APPLYING TO PREP-IB If applying for Prep-IB, please indicate your subject preferences by selecting one of the following subjects in Arts and in Combined Science (IGCSE): Arts subjects: Theatre Arts OR Visual arts Combined Science (IGCSE): Combined Science is taught as one level. In the event of the establishment of individual sciences, please indicate preference
Biology (IGCSE)
OR
Chemistry (IGCSE)
OR
Physics (IGCSE)
STUDENTS APPLYING FOR IB If applying for IB, please indicate your preliminary interest by selecting subjects and levels: Group Group 1: Language and literature
Subject English A Danish A Self-taught A
Max 3 SL level
Max 3 HL level
SL SL SL
HL HL
Group 2: English B Language acquisition Danish B
SL SL
HL HL
Group 3: Individuals and societies
Economics History Psychology
SL SL SL
HL HL
Group 4: Sciences
Biology Chemistry Physics
SL SL SL
HL HL HL
Group 5: Mathematics
Mathematics
SL, HL or Studies Math level is chosen later
Group 6: The Arts
Theatre Visual Arts
SL SL
APPLICATION FORM FOR PREP-IB AND IB
HL HL
CHOOSE 6 SUBJECTS IN TOTAL You must choose 1 subject from group 1-5 You must choose 1 subject from group 6 OR an additional subject from Group 3 or 4. You may NOT choose the following subject combinations: - Economics AND Biology - History AND Physics - Psychology AND Chemistry Math level is chosen after consultation with our math teacher. These choices are only preliminary. When accepted, you must fill in a final form, sign, and return it to our IB Coordinator.
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APPLICATION FORM BOARDER PREP-IB AND IB THE STUDENT’S WEEKEND ADRESS The school will register the student as staying with the guardian in weekends. If the student has a different residence or contact address in weekends, please fill in below. Title:
Place name:
Name: Address: Postal code, city and country: Private phone:
E-mail:
Cell phone:
Work phone:
INSURANCE It is the guardian’s responsibility to make sure that the student has sufficient insurance coverage, especially in regards to travel, liability, accident, and personal property. It is possible to sign for a youth insurance with one of the school’s insurance companies. Learn more about or be advised as to insurance matters at Direktionskontoret, phone +45 55 75 35 01.
BILLING INFORMATION If the billing address is not identical with the guardian’s, please fill in the correct billing address below. Billing statements will be sent to this address quarterly. Title:
Place name:
Name: Address: Postal code, city and country: Private phone:
E-mail:
Cell phone:
Work phone:
We recommend using PBS (Danish electronic payment service): Bank name:
Bank address:
Name on account:
CPR. no.:
Bank ID no.:
Account no.:
Date:
Signature:
APPLICATION FORM FOR PREP-IB AND IB
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APPLICATION FORM BOARDER PREP-IB AND IB POSTAL ADDRESS If you wish school malings to be sent to a different address than the guardian’s, please fill in below: Title:
Place name:
Name(s): Address: Postal code, city and country: Sometimes postal services may be unreliable or slow. The school offer to sent information by e-mail instead of regular mail. Do you wish to receive school mail electronically:
Yes
No
ADDITIONAL INFORMATION Please enclose or attach the following information: Tick the box
Type of attached/enclosed information
Copy of birth certificate
Copy of passport
Copy of most recent report card
Health report
A photo of the applicant
The applicant must have a Danish passport or residence permit in order to attend school in Denmark. If the student is not a Danish citizen, please provide a copy of the residence permit before the beginning of the school year. Upon receiving your application, we will schedule an interview and an admissions test in Math and English. SIGNATURES Deadline for application: April 1st for the academic year beginning in August the same year. However, applicants may be admitted for as long as capacity allows.
The application is not valid without the guardian’s/guardians’ signature(s). Date: Signature: Date: Signature: In signing the application you confirm that you accept the rules and conditions found in the current edition of the School Handbook - this may always be found on the school’s homepage. You also agree that the school has the right to charge a late fee of DKK 100,- for each reminder of overdue payment. In addition, 1% interest is added to overdue payments each month.
APPLICATION FORM FOR PREP-IB AND IB
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HEALTH REPORT The health report is kept in the school infirmary. You are welcome to meet with the school nurse and elaborate on the information below when you arrive. Name of student: CPR no.:
Grade level in Aug. 20
If you live in Denmark:
National health group:
:
Own doctor:
Name of guardian: CPR no.: Address: Private phone:
Work phone:
Vaccinations - please state year of vaccine: Di-Te-Ki-Pol (diphtheria, tetanus, whooping cough, and polio)
Pneumokok (meningitis, pneumonia)
1:
1:
2:
3:
1:
2:
3:
2:
Di-Te-Ki-Pol revaccine
3:
1:
MFR (measles, mumps, and german measles) 1:
HPV (cervical cancer, genital warts, etc.) Other vaccinations:
2:
In case of previous serious medical conditions, please state the types, hospitalisations, operations, and treatments:
Allergies:
Does the student take any medication? Please state name/dosis:
Concerns regarding food, physical activity, etc.:
Please note, that the school’s diet does not include vegetarians.
Other health issues the school should know about:
APPLICATION FORM FOR PREP-IB AND IB
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