our future

Application Form

Student Information
First Name:  
Middle Name:
Last Name : 
Email Address: :

Gender: :

 Male Female
Date of Birth: Year Month Day
Country of Birth:
Nationality:
Passport Number:
Mother Tongue:
Religion
Year Applied to:
Beginning
Schooling Background
 
   
Name of Present School:
Postal Address:
Name of Headteacher:
   
Family Background
 
   
Are there/ have there been any brothers or sistersat St. Austins Academy: Yes No
if yes give details
   
Other Requirement
 

Please indicate if the following are required
(tick all those that apply):

Lunch Transport Boarding
   
Medical Background
 

Does your child suffer from
(tick all those that apply):

Eczema Asthma Sinusitis Hayfever
other(specify)
if the answer to any of the above is "yes", does your child know what to do in the event of an attack (specify):
if the answer to any of the above is "yes", does your child need to take medication?
(specify)
Does you child have any allergies, such as to bee- stings, penicillin/ antiseptic?
(specify)
Incase of a minor ache, do you authorise St Austins Academy to give your child aspirin products?
(specify)
   
To which hospital(s)should your child be taken in the event of an emergency
Physical Address :
Family Doctor:
Telephone:
Who else should be contacted in an emergency, other than Father/ Mother as detailed on the family form?
Telephone