Application form

Child's surname *

Child's names *

Date and place of birth *

Child's adress *

School attended by child *

Name, Address, telephone number of GP *

Additional medical information

e.g. allergies, prescribed medication, etc.

Additional needs

ADHD confirmed by specialist, dyslexia- documentary proof required

1st Parent's / main guardian's surname *

1st Parent's / main guardian's name *

1st Parent's / main guardian's adress *

1st Parent's / main guardian's telephone number *

1st Parent's / main guardian's email adress *

Name of 2nd parent / gurdian with legal access *

Adress of 2nd parent / gurdian with legal access *

Telephone number of 2nd parent / gurdian with legal access *

Email adress of 2nd parent / gurdian with legal access *

Is there any way you can contribute to the running of the school by helping with organisation of special events, information technology, arts and crafts, informative talks for children relating to special interesting hobbies or professions or experiences?

In what way could the school help you and your child?

Preferred form of payment *

Bank transfer

Cheque