APPLICATION FORM BOARDER PRIMARY SCHOOL ABOUT THE STUDENT This is an application for boarding students starting
grade in August
Full name: Address: Postal code and city:
CPR no.:
County:
Country:
Current school: 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/FARTHER) Title:
CPR no.:
Name: Address: Postal code, city and country: Private phone:
E-mail:
Cell phone:
Work phone:
CO-GUARDIAN (MOTHER/FARTHER) 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 PRIMARY SCHOOL
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APPLICATION FORM BOARDER PRIMARY SCHOOL 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
PRIOR LINGUAL COURSES German
French Other:
OTHER INFORMATION ABOUT THE STUDENT Applicant’s hobbies:
Students in the 8th grade can opt to attend confirmation classes and be confirmed in Herlufsholm Church . Student wish to attend confirmation classes and be confirmed:
APPLICATION FORM FOR PRIMARY SCHOOL
Yes
No
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APPLICATION FORM BOARDER PRIMARY SCHOOL 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 PRIMARY SCHOOL
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APPLICATION FORM BOARDER PRIMARY SCHOOL 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 PRIMARY SCHOOL
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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 PRIMARY SCHOOL
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