Register - Birkdale School

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1. Proposed date of entry to school *

Child’s first name's *

Child's preferred name (if different to above)

Year group *

Child’s surname *

Religious affiliation (if applicable)

Date of birth *

Gender *

Type of Place: *

Prep School

Senior School

Sixth Form

2. Child’s present school/preschool/nursery *

Address *

Head Teacher's name *

As part of the entry procedure we would normally contact the Head Teacher, unless you inform us otherwise

Date of entry to school *

3. Has your child attended Birkdale before? *

Yes

Is a sibling a current/former pupil? *

Yes

Name

Sibling Name

Title of father/guardian *

Name of father/guardian *

Address

Email *

Occupation *

Home telephone no.

Daytime emergency tel no. *

Mobile no *

Please tick box to indicate that your child normally resides at this address

Yes

Title of mother/guardian *

Name of mother/guardian *

Address

Email *

Occupation *

Home telephone no.

Daytime emergency tel no. *

Mobile no *

Please tick box to indicate that your child normally resides at this address

Yes

4. Do you wish to apply for a scholarship? (S1/Y7 and Sixth Form only)

Please see further guidance provided in the prospectus pack or in the Scholarships and Bursaries section on our website for further information.

11+ (S1/Y7)

Academic (by invitation)

Music

Sports

Sixth Form

Academic

Music

Sports

5. Is your acceptance of a place conditional on receiving means-tested Bursary assistance? *

Yes

If Yes please also submit a Bursary Application and supporting documentation. Please see further guidance provided in the Scholarships and Bursaries section on our website for further information.

6. Please provide details of any medical conditions (including allergies), learning difficulties or disabilities your child may have. We will contact you to request further information.

7. Will your child require any specialist facilities to attend an entrance interview or take an entrance exam/test?

8. How did you hear about Birkdale? *

Recommendation

Our website

Newspaper/Magazine Advertising

Social Media

Notes: Early registration is recommended. Offers of places are subject to availability and the admission requirements of the School at the time offers are made. A copy of the current edition of the standard terms and conditions will be supplied on request.

Declaration

We request that our above-named child be registered as a prospective pupil. We have paid the non-returnable £50 registration fee using the method indicated below: *

Bank Transfer Account name: Birkdale School Sort Code: 40-23-67 Account Number: 60019127

Debit card payment by telephone (0114 266 8400)

Card payment online (www.birkdaleschool.org.uk/payments)

We understand that the standard 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. Privacy notices can be found HERE

Signed Parent or Guardian 1 *

Signed Parent or Guardian 2

Birkdale School, 4 Oakholme Road, Sheffield, S10 3DH I Telephone: 0114 266 8408

Company No: 02792166 Charity No: 1018973