Student's Details

* marks required fields
First Name*:
Date Of Birth*:
Current school including address:
Please provide us with details of any medical condition (including allergies), disabilities or learning difficulty of your child:

Parents' Details

First Parent's Name
Email Address*:
Home Telephone:
Mobile Telephone:
Second Parent's Name
Email Address:
Home Telephone:
Mobile Telephone:

Additional Details

Please mention here the names of any other members of the family attending the School or registered for entry; or any other connection with the School:
Please say how you heard about the Scholarship awards;

We request that our above-named child be registered for the Charles Dickens Scholarship Award 2020, and we understand that whether or not a Scholarship is awarded, along with the level of any award offered, is at the sole discretion of the School and that there is no right to appeal or challenge the decision of the School.

We understand that the School is unable to return our child’s examination papers.

We understand that the 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.

I have read and agree to the above declaration
Data Protection

The School will process personal data about you and your child in accordance with the Data Protection Act 1998 (as amended or superseded, including from 25 May 2018 the General Data Protection Regulation) and other related legislation. We will process such personal data:

(i) as set out in the School’s standard Terms and Conditions as are in force from time to time, and in the school's 'Data Protection Notice' which is available on the school's website as may be amended from time to time;

(ii) in order to comply with any court order, request from or referral to an appropriate authority, or legal, regulatory or good practice requirement; and

(iii) where otherwise reasonably necessary for the school's purposes
Please Note: Your data will not be used for any marketing purposes unless you provide explicit consent in the section below.

I have read and agree to the above data protection notice.