Mary Broad Award Application

Date Application Complete(Required)

Full name of pupil (as on birth certificate)(Required)

First Last

Date of Birth(Required)

Term and year of entry(Required)

Please tick if applicable(Required)

Day

Weekly Boarding

Flexi Boarding Place

Full Boarding Place

Nationality(Required)

Title of person(s) with parental responsibility(Required)

Full Name(s) of person(s) with parental responsibility(Required)

First Last

Email Address 1(Required)

Phone Number 1(Required)

Occupation(Required)

Title of person(s) with parental responsibility

Full Name(s) of person(s) with parental responsibility

First Last

Email Address 2(Required)

Phone Number 2(Required)

Occupation(Required)

Full Address of person(s) with parental responsibility including postcode(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Siblings already attending Talbot Heath

Current School and Address(Required)

Is your child to follow Talbot Heath's normal course of Religious Education?(Required)

Yes

No

Does your child have any history of learning difficulties such as Dyslexia, Dyspraxia, etc?(Required)

Does your child have any visual, aural or other physical impairment, which might require consideration during the entrance procedure or during her time at the school?(Required)

Subjects being studied to GCSE(Required)

Proposed subjects to be studied at A Level(Required)

Oversea Applicants Public examinations taken

Scholarships & Bursaries

Please indicate by clicking on the appropriate boxes of the following scholarships you wish your daughter to be considered.

Individual Scholarships – Please tick all that apply

Natalie Clein or Kate Royal Music Scholarship

Isabel Davis Sport Scholarship

Rebecca Newnham Art Scholarship

Louisa Clein Drama/Performing Arts Scholarship

Fiona Marshall Academic Scholarship

Swimming Scholarship

Tennis Scholarship

Bursary

Mary Broad Award

I/We hereby apply for the admission of(Required)

to the School, from and including the year and term mentioned in the application form.

I/We have read and understand the Declaration below.

Yes

No

PLACE REQUEST

Sixth Form

Declaration

I/We understand that

Please type in capitals the names of all persons with parental responsibility for the pupil being registered to confirm your form submission.(Required)

Data Protection: Talbot Heath School Trust Ltd, as a Registered Data user, has an obligation to comply with the principles of the Data Protection Act 1998. Any personal details collected on this form will only be used for the purpose(s) stated. This information will be kept securely and will not be passed on to any third parties without the data subject’s consent. Information will not be kept longer than is necessary. Any queries regarding Data Protection should be sent to the Headmistress.

School Life

Parents, Pupil and staff Area

Charity

Junior School

Senior School

Sixth form

Talbot Heath School Sixth Form Application – Mary Broad Award Candidates

Scholarships & Bursaries

PLACE REQUEST

Declaration

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