RICHMOND HOUSE SCHOOL
168-172 Otley Road, Leeds LS16 5LG
Telephone: 0113 275 2670 Fax: 0113 230 4868

REGISTRATION FORM
(Request for a Place on the Waiting List)

 (Please print out this form, complete it and post to the school at the address above)

1.             Surname of Your Child:

                First Names:

                (Please underline the name generally used)

                Date of Birth:                                                        Nationality:                                           Religion:

                Gender:                                                                  o  Male                 o  Female

                Type of Place: (please tick)                                   o Nursery             o Reception         o Years 1-6

                Proposed Term and Year of Entry:                                  

                Have you registered your child’s name at any other school/s and if so, which?

 


2.             Father’s Title, Full Name, Address and Occupation:

 

 

 

               

Daytime Telephone:                                                            Evening Telephone:                                           

 

 


3.             Mother’s Title, Full Name, Address (if different from the above) and Occupation:

 

 

 

 

                Daytime Telephone:                                                            Evening Telephone:                                           

 

 


4.             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.

 

 

 

 


5.             Please say how you first heard of the School.  Was it from:

 

                o Local Reputation                             o Present School                                o Friends

                                                                                                                               

o Advertisement                                 o Other (Please give details)

 

 

6.             Please state the name and address of  present school or nursery:

 

 

                Name of Head or Principal:

 

 

Notes

Early registration is recommended.  Registrations will be considered in the order they are received.  Offers of places are subject to availability and the admission requirements of the School at the time offers are made.  A copy of the current edition of the standard terms and conditions will be supplied on request.

DECLARATION 

We request that the name of our above-named child be registered as a prospective pupil.  A cheque for the non-returnable registration fee of £25.00 is enclosed.  We understand that the standard 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.

 

Signature:            ……………………………………………………………………………………………….              

 

Name in full:          ……………………………………………………………………………………………….

 

Relationship to the Child:   ……………………………………………………………………………………..

 

Date:                       ……………………………………………………………………………………………….

Richmond House School Association:  a company limited by guarantee

Registered in England No:  01270675

Registered Office:  168-172 Otley Road, Leeds LS16 5LG

Registered Charity No:  505630