Registration form Please complete this form to register your interest in Clifton High School. The Admissions Department will then contact you with all the necessary information. There is no registration fee. PLEASE USE BLOCK CAPITALS Surname of child:
First names (in full):
Name generally used:
Date of birth:
Gender: Male
Nationality:
Female
Proposed date of admission (term and year)
Home Boarding
Registration for: Day
Parents’ Details Mother
Father
Name (with title): Address (with postcode):
Occupation: Nationality: Home tel: Work tel: Mobile: Please indicate preferred telephone number for school to contact you on: Email: School attended: Guardian details if applicable (please note that the appointment of a guardian is compulsory if both parents are non-UK residents) Title:
Email:
Name:
Home Tel:
Address:
Work Tel: Mobile:
Occupation:
Please indicate preferred telephone number for School to contact your child’s guardian:
Nationality: Please mention here the names of any other members of your family who attended Clifton High School or any other connection you may have with the school:
College Road, Clifton, Bristol BS8 3JD e-mail: enquiries@cliftonhigh.bristol.sch.uk web: www.cliftonhigh.bristol.sch.uk Facsimile: 0117 923 8962
School Office: 0117 973 0201 Admissions: 0117 933 9087 Finance: 0117 973 3853
Please state the name and address of your child’s/children’s present school:
Name of Head Teacher at your child/children’s present school: Clifton High School is a selective school where the expectation is that children will thrive and perform well academically. Consequently it is important that the school has all the information required to assess if the school can meet any particular needs. Please tick as appropriate: Does your child have any identified special educational need or disability?
Yes
No
Are there any circumstances relating to your child of which the school should be aware, for example has your child ever seen or been recommended to see an Educational Psychologist?
Yes
No
In order to give the very best support to your child it is important that we are made aware of any particular recommendations in Educational Psychologist or specialist teacher assessment reports that have been written about them. This includes current reports as well as those that may have been written earlier in your child’s education. Please could you include a copy of the most recent Educational Psychologist or specialist teacher assessment report and indicate if any of the following apply to you child by ticking the relevant box: Attention Deficit Hyperactivity Disorder
Yes
No
Specific Allergies
Yes
No
Attention Deficit Disorder
Yes
No
Dyslexia
Yes
No
Hearing Impairment
Yes
No
Dyspraxia
Yes
No
Visual Impairment
Yes
No
Dyscalculia
Yes
No
Aspergers Syndrome
Yes
No
Autism
Yes
No
Processing difficulties (verbal and visual)
Yes
No
Mobility impairment
Yes
No
Other
Yes
No
Speech and Language Disorder
Yes
No
If yes please give more detail:
It is also as important to know if your child has been identified as Gifted and Talented in any particular curriculum area. My child has been identified as Gifted and Talented in the area of:
Are there any special arrangements or reasonable adjustments that may need to be made for your child to attend a taster day?
Yes
No
Yes
No
Does your child hold a UK, EEA or Swiss passport?
UK
EEA
If not, does he or she have permission to reside in the UK?
Yes
No
If yes, please give details: Is English your child’s first language? If not, please state his/her first language:
Please give details of any relevant visas, and dates of expiry
Swiss