Apply for a Place

To apply for a place at Luckley House School, please complete the online Registration Form.

To be submitted with the registration fee of £100.

Pay via BACs to LUCKLEY HOUSE SCHOOL Sort Code 60-24-21
Acc Number 67743811

DETAILS OF CHILD

Child's Full Name

Date of birth

Gender
MaleFemale

Type
Day PupilFull BoarderWeekly Boarder

Home Address

Address

Address 2

Town/City

County

Postcode

Country

Year of Entry

Year Group Entry

Nationality

Child's First Language

For a child whose nationality is non-European

The School is a registered Tier 4 sponsor (via the Home Office's UK Visa and Immigration (UKVI) unit). Please tick this box if you may require the School to sponsor your child for visa/immigration purposes.

Yes

Details of the Tier 4 sponsorship arrangements will be sent to everyone who ticks this box. Providing this information does not guarantee that the School will sponsor your child or that the School is somehow obliged to. The School reserves full discretion over any decision whether or not to sponsor your child.

If you do not require the School to sponsor your child please confirm that your child has or will have a time-restricted or temporary visa in any other immigration category (for example as a dependent) and please email a copy to Registrar@luckleyhouseschool.org.

In the case of boarders whose parents will be resident abroad please give name, address and telephone number of a relative or other person in this country who will act as a Guardian and accept responsibility for the pupils during school holidays. A form of consent will be sent to the person nominated for signature before the pupils' entry to the school.

PREVIOUS SCHOOLS

Name and Addresses of Schools attended, with dates

PARENTS' DETAILS

PARENT 1

Title

Name

Profession

Home Address - if different from child

Home Phone

Mobile Phone

Email

PARENT 2

Title

Name

Profession

Home Address - if different from child

Home Phone

Mobile Phone

Email

ADDITIONAL INFORMATION

Names and ages of other children in the family

Any important information relating to home circumstances:

Please give brief details of any disability, medical condition or special needs - further details will then be requested separately:

FINANCIAL ASSISTANCE

Do you wish to apply for means tested bursary assistance towards the fees?

YesNo

Bursary assistance may be offered subject to confirmation of financial status and is subject to annual review. A meeting with the Finance Bursar will be arranged for any applicant who ticks the box above.

DECLARATION

I/We (as the holders of parental responsibility) request that the name of the above-named child be registered as a prospective pupil of Luckley House School AND we agree to pay via BACs or cheque the non-refundable Registration Fee of £100.

Pay via BACs to LUCKLEY HOUSE SCHOOL Sort Code 60-24-21
Acc Number 67743811

By signing this Registration Form I/we understand, accept and agree that:

1. registration of our child as a prospective pupil does not secure our child a place at the School but does ensure that our child will be considered for selection as a pupil at the School;

2. if our child is offered a place at the School, such an offer will be subject to the School's terms and conditions for the provision of educational services, which will bind us (as the holders of parental responsibility for him/her) in the event (and from the moment) that we accept the place;

3. In order to comply with our responsibilities as a registered Tier 4 sponsor, you consent to us notifying and/or supplying information relating to you and/or your child's right to enter, reside and/or study in the United Kingdom to the United Kingdom Visas and Immigration (UKVI) unit of the Home Office and, in any event, if our child is offered a place at the School, such an offer will be subject to us confirming that our child has the right to enter, live and study in the United Kingdom;

4. if applicable, the School may request from our child's present school or educational institution: (a) information and a reference in respect of our child; and/or (b) information about any outstanding fees and/or supplemental charges;

How we may use personal information

The School may process personal data about you (or either of you) and your child, including sensitive personal data about our child (such as medical details) in accordance with data protection law for the purposes of:

(i) administering its list of prospective pupils;
(ii) its registration, selection and/or admission procedures, including as set out above; and
(iii) communicating with the parents of prospective pupils about the School and generally managing relationships between the School and its prospective pupils.

Even if your child is not offered a place at the School, we retain information about prospective pupils and their parents for one year. Please let the Bursar know if you have any questions or concerns about this.

Further information about how the School processes personal data is set out in the School's Privacy Notice, which is on the School's website and is otherwise available from the School at any time upon request.

I / We understand that the personal data provided above will be processed for the purposes set out in Luckley House School's Privacy Notice.

For the purposes of data protection law, Luckley House School is the data controller for any personal data you supply to us. This personal data will be processed in accordance with data protection law, only used for the purpose(s) for which you have supplied it to us and our Privacy Notice, and (except where you have consented) only shared with third parties where it is necessary for us to do so and the law allows it. please tick

Name of person submitting this form

Date of Application

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