UK Student Registration Form

Biological Parent/Legal Guardian 2 details:

If the student is no longer in contact with biological parent 2, please provide an additional contact.
Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*

Confirmation Email
Mobile Number*

Area CodePhone Number
Phone Number

Area CodePhone Number
Work Number

Area CodePhone Number
Occupation*
Does the student live with Parent/Guardian 2?*

YesNo
Please indicate relation to student*

Please identify the person(s) to whom school correspondence should be sent to:*

FatherMotherGuardian 1Guardian 2
Declaration

We agree to accept the School’s Standard Terms and Conditions. The non-returnable registration fee of £75 payable to Rossall School is enclosed. We certify that the above named student has not been dismissed or removed from any School or college on account of misconduct. We understand that registration does not constitute the offer of a place at the School.
Parent/Guardian 1 Signature*
Date*
Parent/Guardian 2 Signature*
Date*

Payment

Registration Fee - This is in addition to the tuition fees and is non-refundable. Please note, you will be sent through to World Pay to complete the booking when you submit this form.
Rossall Registration Fee Payment*
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Registration Fee£100.00

Are you an organisation, completing the registration form on behalf of the parents?*

YesNo

Name of organisation
Contact name
Position
We confirm that the information supplied is true, to the best of our knowledge and that we have explained the above requirements regarding notice of withdrawal, to the parents. Signed:
Date

Please click the 'submit' button below, to submit your application to Rossall.

Registered Charity No. 526685 Authorised to sign on behalf of the above organisation
Should be Empty: