Registration Form

Request for a place

Registration Form Please write clearly in block capitals throughout Please ensure that you complete all sections

Your child Surname of your child First name Preferred name Please attach a photograph

Date of birth Religion Nationality First language

Type of place (please tick) Upper School:

Boarding

Weekly Boarding

Day Pupil

Sixth Form:

Boarding

Weekly Boarding

Day Pupil

I/We are interested in receiving information on scholarships and/or bursaries (please tick). Please send me the relevant application forms Academic Scholarship

Art Scholarship

Music Scholarship

Drama Scholarship

Sports Scholarship

Bursary

Please note: scholarships and bursaries are only offered at 13+ and 16+

Proposed year of entry

Proposed year group at entry

Sixth Form applicants only. Please indicate your preferred choice of qualification, if known AS/A Level

Have you registered your child’s name at any other school/s and if so, which?

International Baccalaureate Diploma

Parent/Legal Guardian 1 Title (Mr, Mrs, Miss, Ms, Dr)

(This should be the person with whom the School corresponds and who, ultimately, will be responsible for the fees. This person is not necessarily the one with whom the boy resides)

Full name

Relationship to child

Nationality

Address Postcode Home telephone

Mobile telephone

E-mail address Occupation Employer’s business name and address Relationship to Parent/ Legal Guardian 2

Please tick this box if Parent/Legal Guardian 1 is an Old Bedfordian

Parent/Legal Guardian 2 Title (Mr, Mrs, Miss, Ms, Dr)

Full name

Relationship to child

Nationality

Address Postcode Home telephone

Mobile telephone

E-mail address Occupation Employer’s business name and address Relationship to Parent/ Legal Guardian 1

Please tick this box if Parent/Legal Guardian 2 is an Old Bedfordian

If Parent 1 and Parent 2 live at separate addresses, please indicate with whom the boy has permanent residency Parent 1

Parent 2

Family information – other people with parental responsibility Please provide the name/s and current address/es of any other person with parental responsibility (i.e. legal responsibility). Their consent for the child to attend the School will be required if an offer of a place is made Title (Mr, Mrs, Miss, Ms, Dr)

Full name

Address Postcode

Siblings Sibling 1 full name Gender

Male

Female

If male, is he a pupil at Bedford School?

Date of birth Yes

No

Sibling 2 full name Gender

Male

Female

If male, is he a pupil at Bedford School?

Date of birth Yes

No

Sibling 3 full name Gender

Male

Female

If male, is he a pupil at Bedford School?

Date of birth Yes

No

Please mention here the names of any other family members attending the School or registered for entry, or any other connection with the School (e.g. staff, Old Bedfordians)

Current school details Please state the name and address of your child’s present school Name and address of school

Telephone number E-mail address Website Name of Head Date of joining

Date of leaving

The school has been informed of our intentions and we are happy for you to contact them: Yes

No

Please confirm whether your child will require sponsorship from the School in order to obtain a visa to study in the United Kingdom at Bedford School Yes

No

Please outline your child’s artistic, dramatic, musical or sporting skills or experience, and their hobbies and interests

Please provide details below or on the Confidential Information Form (last page) of any medical condition, health problem or allergy affecting your child; any learning difficulty, disability, or special educational need of your child, as well as any behavioural, emotional and/or social difficulty of your child, if applicable

Please indicate how you first heard of Bedford School. Was it from: Local Reputation

Present School

Friends

Website

Agent

Family Connection

Advertisement Other (please give details)

Notes Early registration is recommended. 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 that offers are made. A copy of The Harpur Trust’s Terms and Conditions will be supplied on request or can be viewed on the School website. If you would like further information about how the School processes personal information, please see our privacy notice document How we use your information which is published on our website. The completion and return of this registration form does not constitute any binding agreement upon you or The Harpur Trust. Parents must advise the Admissions Department in writing if one or more of the conditions below is/are applicable. • • • •

Both parents are NOT jointly responsible for their son’s education One parent has an objection to their son attending the School Consent to attend the School is required from an additional individual An individual other than the boy’s parents or guardians will pay or guarantee payment of fees

All details provided will be treated in confidence. Declaration I/We request that the name of our named child be registered as a prospective pupil. I/ We understand that the School may obtain, process and hold personal information about me/us which may include financial information provided by me/us or by any licensed credit reference agency or information contained in any court orders, petitions or proceedings. I/ We understand that the School may also obtain, process and hold personal information about our child which may include sensitive information such as medical details, and I/ we consent to this for the purposes of assessment and, if a place is later offered, in order to safeguard and promote the welfare of the child. I/ We enclose the non-refundable registration fee of £100 together with this completed registration form duly signed by me/us. Please tick to confirm that you have enclosed: Non-refundable registration fee of £100 (cheques made payable to The Harpur Trust or proof of bank transfer) Copy of birth certificate (UK students) or a copy of passport photograph page (international students) Educational Psychologist’s Report (if applicable) Photograph Signed and dated registration form

Both parents/guardians of the above-named child are required to sign this registration form Parent/Guardian 1 Signature Full name (please include all names)

Date

Parent/Guardian 2 Signature Full name (please include all names)

Date

Ethnicity Form Our ethnic background describes how we think of ourselves. This may be based on many things, including, for example, our skin colour, language, culture, ancestry or family history. Ethnic background is not the same as nationality or country of birth. The Information Commissioner recommends that young people aged 12 years or older have the opportunity to decide their own ethnic identity. Parents or those with parental responsibility are asked to

support or advise those children aged 12 years or older in making this decision, wherever necessary. Pupils aged 16 or over can make this decision for themselves. Please study the list below and tick one box only to indicate the ethnic background of the child named in the registration form attached to this form. Please also tick whether the form was filled in by a parent or the child.

Name of Child White British – English, Scottish or Welsh

Irish

Any other white background

African

Any other white background

Black or Black British Caribbean

Chinese or other Ethnic Group Chinese

Any other Ethnic Group (please give details)

Mixed Race White and Black Caribbean

White and Black African

White and Asian

Any other mixed background

Indian

Pakistani

Bangladeshi

Any other Mixed Background Asian or Asian British Any other Asian background (please give details) This information was provided by Parent

Child

Please return the form to the School with your completed registration form (Any information you provide will be used solely to compile statistics on diversity within the School. These statistics will not allow individual children to be identified)

Confidential Information Form All information received in this form will be treated in confidence

Child’s full name Name of Parent/Guardian (1) Name of Parent/Guardian (2)

Under the School’s Special Educational Needs Policy (available on the School Intranet) you have the opportunity to disclose: • any medical condition, health problem or allergy affecting your child • any learning difficulty, disability, or special educational need, as well as any behavioural, emotional and/or social difficulty affecting your child • access arrangements are in place for examinations, such as extra time, use of a word processor, etc. This will enable the School to consider any adjustments that it may need to make to assist your child to partake in the School’s admissions procedure or when he enters the School. Please provide us with as much detail as possible in the space below. Where possible, please provide any relevant documentation such as medical reports, assessments etc.

Bedford School, De Parys Avenue, Bedford, MK40 2TU Tel: +44 (0)1234 362216 Fax: +44 (0)1234 362283 Email: [email protected] www.bedfordschool.org.uk Bedford School is part of The Harpur Trust: a company limited by guarantee Registered in England: Company Number: 3475202 Registered Office: Pilgrim Centre, Brickhill Drive, Bedford, MK41 7PZ Registered Charity Number: 1066861