Selected Year

Select one Early Years Prep School Senior School Sixth Form

1. Surname of Child

2. First Name of Child

3. Gender *

4. Child's Date of Birth

5. Ethnicity *

6. Religion *

7. Child's First Language *

8.Proposed Start Date (please estimate if unsure)

9.Other schools you have registered your child with:

10.Adult Contact 1: First Name

11.Adult Contact 1: Surname

12.Adult Contact 1: Relation to Pupil (e.g. mother, father, grandparent etc.)

13.Adult Contact 1: Title *

14.Adult Contact 1: Occupation

15.Adult Contact 1: Phone Number

16.Adult Contact 1: Email Address

17.Adult Contact 1: Home Address

18.Adult Contact 2: First Name

19.Adult Contact 2: Surname

20.Adult Contact 2: Relation to Pupil (e.g. mother, father, grandparent etc.)

21.Adult Contact 2: Title *

22.Adult Contact 2: Occupation

23.Adult Contact 2: Phone Number

24.Adult Contact 2: Email Address

25.Adult Contact 2: Home Address

26.Names of any other members of the family who currently attend, are registered with or have any other connection to Priory School:

27.How did you first hear about Priory School? *

28.Name of Current School

29.Name of Current Head Teacher

30.Current School's Address

31.Name of Current Head Teacher

32.Current School's Email Address

33.Please list the names of any fee-paying school/s you have attended together with dates

34.Please provide us with details of any medical conditions (including allergies) or disabilities. Please list both physical and psychological conditions. Kindly note that withholding important medical details may result in your child's offer of a place being withdrawn, should we later discover that we do not have the facilities to cater to their needs.

35.Please provide us with details about any specific learning difficulties, e.g. dyslexia, dyspraxia, dyscalculia etc. Please send any relevant supporting documents (e.g. school reports, Educational Health Care Plans etc.) to admissions@prioryschool.net.

36.We request that our above-named child be registered as a prospective pupil. The total £50, non-refundable registration fee has been paid to the school by cheque, cash, card or by bank transfer to the following details:
Account Name: Priory School
Bank Name: Handelsbanken
Account Number: 12292365
Sort Code: 40-51-62

We understand that the terms and conditions of the School will undergo reasonable changes from time to time as circumstances require and will apply in all our dealings with the School. We understand also that the School (through the Head, as the person responsible) may obtain, process and hold personal information about our child, including sensitive information such as medical details, and 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.

In ticking the "I consent" boxes below, we accept that this acts in place of giving a written signature, to confirm that we have read and agreed with these terms.

Adult Contact 1: I consent
Adult Contact 2: I consent