Admissions Application Form

Child Details

Legal Surname (Family Name) *

Legal Forename(s) (First Names) *

Preferred Forename

Address 1 *

Address 2

Town/City *

County *

Post Code *

*We will use your child's home address 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

Gender *

FemaleMale

Does your child hold an EU or a Non-EU passport?*

EU passport holder  Non-EU passport holder 

Please tell us what type of passport your child holds (E.g. 'British' or 'French' etc.)?*

Does your child have special educational needs?*

No  Yes 

Does your child have English as an additional language? *

No  Yes 

Does your child have a disability? *

No  Yes 

If 'yes' to any of the questions above, we will contact you to discuss whether reasonable adjustments need to be made to our assessment procedures

Proposed year of entry? (eg. sept 2012) *

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

Pre-nursery (turns 3yrs old during academic year) Nursery Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 12

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 *

Please select...MrMrsMissMsDrMx

Full Name *

Home Telephone *

Daytime Telephone *

Email *

Relationship to child (eg. mother, step parent, legal guardian etc) *

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

Parent/Guardian 2

Title

Please select...MrMrsMissMsDrMx

Full Name

Home Telephone

Daytime Telephone

Email

Relationship to child (eg. mother, step parent, legal guardian etc)

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 be considered for a means-tested bursary

Yes  No 
Year 7 and Year 12 entrants only may apply

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

Yes  No 
Year 7 entrants only may apply

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

Present school or nursery

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 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. I/We understand that by submitting this form we consent to The Grammar School at Leeds contacting the present school or nursery named above with regard to obtaining a confidential report.

All information collected will be held, used and/or stored in accordance with the school’s privacy notice. All personal data is held in accordance with applicable Data Protection laws. For more information on how GSAL process your personal data please contact our Data Protection Lead, Vicki Lawson, by emailing dpo@gsal.org.uk.

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.