Child Details

Surname (Family Name) *

First Name(s) (Legal Forename) *

Preferred Forename

Address 1 *

Address 2

Town/City *

County *

Post Code *

*Your Child's home address will be used for all communications unless you inform us otherwise

Date of birth *

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994

Gender *

FemaleMale

Does your child have a disability? *

No  Yes 
If 'yes' we will contact you to ascertain what reasonable steps we can take to ensure our assessment procedures do not discriminate.

When would you like your child to enter school? (e.g. sept 2012) *

In what year group would you like your child to enter school (E.g. Year 7)?

Nursery Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Lower Sixth Upper Sixth

At what age would you like your child to enter school?

3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Parent/Guardian 1

Title *

MrMrsMissMsDr

Name *

Home Telephone *

Daytime Telephone *

E-Mail *

Same as child's address
Yes  No 
If different please give separate address at the end of the form below.

Parent/Guardian 2

Title

MrMrsMissMsDr

Name

Home Telephone

Daytime Telephone

E-Mail

Same as child's address
Yes  No 
If different please give separate address at the end of the form below.

Separate address for parent/guardian (if relevant)

Address 1

Address 2

Town/City

County

Post Code

Bursaries, Scholarships and Relatives

Tick box if you wish to to considered for a means-tested bursary

Yes  No 
Yr 7 and Lower Sixth entrants only may apply

Tick box if you wish your child to to considered for a music/instrumental scholarship

Yes  No 
Yr 7 entrants only may apply

Please provide names of any relatives who already attend or have applied for entry to GSAL

Present School

Name of School

Name of Headteacher

Address

Town/City

County

Post Code

Previous School

Name of School

Name of Headteacher

Address

Town/City

County

Post Code

Confirmation

I/We request that the above named child be registered as a prospective pupil. I/We understand that the standard terms and conditions of the school will undergo reasonable changes from time to time and will apply in all my/our dealings with the school. I/We also understand that the school may obtain, process and hold personal information about my/our child, including sensitive information such as medical details, and I/we consent to this for the purposes of assessment and if a place is offered, in order to safeguard my/our child's welfare.

I/We understand that the prospectus accompanying this application form describes the broad principles on which the school is run and that it is not part of any agreement between me/us and the school. I/We understand that, although believed correct at the time of print, certain statements may become out of date from time to time and that I/we should seek written confirmation of any specific statements upon which I/we wish to place specific reliance before accepting the offer of a place.

Signature *

Yes I confirm this information is correct * 

This form must be signed by the parent(s)/guardian(s) applying for admission of the overleaf named child and who it is assumed will be responsible for school fees.