Registration Form

Please complete the registration form below and submit together with a £120.00 registration fee payment which is non-refundable (£100 registration fee plus 20% VAT). Miss Hodgins in Admissions will be in touch to acknowledge your registration shortly. The bank details are below to pay the registration fee on line.

"*" indicates required fields

Daughter's Full Name*

First Last

Name by which your daughter will be known as.*

Calendar Year of Entry*

Year Group of Entry*

Term of Entry*

Daughter's Date of Birth*

Nationality*

Religion*

Title of Parent 1*

Name of Parent 1*

First Last

Relationship to Child*

Permanent Address of Parent 1*

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

Telephone Number - Mobile No. of Parent 1*

Email Address of Parent 1*

Profession / Occupation of Parent 1*

Title of Parent 2*

Name of Parent 2*

First Last

Relationship to Child*

Permanent Address of Parent 2*

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

Telephone Number - Mobile No. of Parent 2*

Email Address of Parent 2*

Profession / Occupation of Parent 2*

If you have parental responsibility for the child in a capacity other than as a parent, please state your relationship here.

Name and address of your daughter's present school or nursery setting.*

Are there any domestic, medical or educational facts which we ought to know?

Are there are dietary requirements for your daughter?

Have you registered at any other school, and if so which?

Have you or any family members attended Stormont? If yes, what years did you/they attend?*

How did you hear about Stormont School?*

Declaration

I accept

DECLARATION We (as holders of parental responsibility) request that the above-named child be registered as a prospective pupil of the School AND confirm that a non-refundable Registration Fee of £120.00 (£100 registration fee plus 20% VAT) has been made by bank transfer to the School. By signing this Registration Form we understand, accept and agree that: • registration of our daughter as a prospective pupil does not secure our daughter a place at the School but does ensure that our daughter will be placed on the School’s Entry List (2) or Waiting List as a pupil at the School; • if our daughter is offered a place at the School, such an offer will be subject to the School’s terms and conditions (parent contract) for the provision of educational services(1); • if applicable, the School may request from our daughter’s present school or education setting: (a) information and a reference in respect of our daughter; and/or (b) information about any outstanding fees and/or supplemental charges; • the School may process any personal data about us and our daughter, including sensitive personal data about our her (such as medical details or SEN details), for the purposes of: i. administering its list of prospective pupils; ii. registration, selection and/or admission procedures, including as set out above; and iii. communicating with the parents of prospective pupils about the School and generally managing relationships between the School and its prospective pupils. (1) A copy of the current terms and conditions (also known as the parents’ contract) is available for your information by requesting a copy from Admissions at any time. Please note that the version of the parents’ contract viewed or provided at that time may be subject to change prior to the point at which time when a place is actually offered. (2) The Entry List contains the names of the first eighteen pupils registered for a Reception Class. Names are then added to the School’s Waiting List. Admissions will work through the Waiting List if and when spaces become available. Names on the Entry list are guaranteed an offer of a place at the appropriate time for the academic year of entry.

Please pay the non-refundable £120 registration fee to: Barclays Sort Code: 20-29-77 Account: 60844942 - PLEASE ADD YOUR DAUGHTER’S NAME AS A REFERENCE

Name in Full of Parent 1*

Relationship to Child*

Name in Full of Parent 2*

Relationship to Child*

Date