Application Form - DOLLAR ACADEMY APPLICATION FOR ENROLMENT by hkksew3563rd

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									DOLLAR ACADEMY                                                                                                                        A passport sized
APPLICATION FOR ENROLMENT                                                                                                            photograph must
                                                                                                                                     accompany this
                                                                                                                                        application.
                                                                                                                                     Please attach to
Please complete one application per child. Please print clearly.
                                                                                                                                         this box.
PROPOSED DATE OF ENROLMENT : …………………………                                                   Da y              Boarding

PUPIL INFORMATION

Surname: ……………………………………………………………………………………………………………………………………………………………....

Forename(s): ……………………………………………………………………………………………………………………………………………………..…..

Date of Birth: ………………………………………………………...

Nationality: …………………………………………………………..                                                     Male                    Female

Current School & Class/Form: ………………………………………………………………………………………………………………………………….…..

Current School Attended From: ………………………………                                        To: …………………………………..

Birth Certificate (a copy of the applicant’s birth certificate should accompany this application):                           Please tick

Passport Photograph (a photograph of the applicant should accompany this application):                                       Please tick

Passport Number (if resident outside the UK and/or if non EEA national): ………………………………………………………………………….…….



ADDITIONAL PUPIL INFORMATION
Please indicate overleaf any relevant matters which may affect the application e.g. siblings currently attending or applying to Dollar
Academy. Please also provide details overleaf of significant issues which may affect the applicant’s school experience e.g. special
needs history, illness, medical condition.

PARENT/GUARDIAN INFORMATION

Parent/Guardian 1                                                                   Parent/Guardian 2

Full Name: …………………………………………………………………….                                              Full Name: …………………………………………………………………....
Address: ………………………………………………………………...........                                        Address: ……………………………………………………………………...
………………………………………………………………………………….                                                    ..…………………………………………………………………………….….
Home Tel: ……………………………………………………………………                                                Home Tel: ………………………………………………………………..…..
Work Tel: …………………………………………………………….............                                      Work Tel: ………………………………………………………………....…..
Mobile: ……………………………………………………………………..…                                               Mobile: ……………………………………………………………………..…
Email: ……………………………………...................................................            Email: ………………………………………………………………………….
Member of Forces in receipt of CEA:                          Yes/No                 Member of Forces in receipt of CEA:         Yes/No


MEANS-TESTED BURSARY APPLICATION FOR PUPILS ENTERING FORM I ONLY

I/We have read and understood the Bursary application information and wish to apply for a place at Dollar Academy subject to the
award of a Bursary.

Signed: ………………………………………………………… Signed: ……………………….…………………………………. Date: ……………………….


DECLARATION
I/We hereby apply for admission to Dollar Academy on behalf of ………………………………………….....................................................
and in the event of enrolment, agree to conform to all school regulations. I/We understand that payment of the Registration Fee will not
guarantee admission to the school. (A Registration Fee of £20 should accompany this application – payable to Dollar Academy and
drawn on a UK cheque or, in the case of overseas accounts, a sterling bank draft.)
NB: A full term’s notice is required before withdrawing a pupil, after accepting any place offered, otherwise a full term’s fee will be
charged in lieu of notice


Signed: ……………………………………………………..… Signed: ………………………………………….……………….. Date: ……………………….



         OFFICE USE ONLY:
         Registration:                                                Receipt No: _______________ Date Received: _______________
         Place Offered:                                       Date:         _______________
                                  The Governors of Dollar Academy Trust is a charity registered in Scotland, No. SC009888
         Acceptance of Place Deposit:                                 Receipt No: _______________ Admission No:    _______________


                                  The Governors of Dollar Academy Trust is a charity registered in Scotland, No. SC009888

								
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