Back to Admissions Overview Fairfield Prep School This form is for applications to Fairfield Prep School. Please note, your application will be processed as soon as we receive this form and your non-refundable registration fee (see details below). Please complete and submit the form below. Fields marked * are mandatory. If you wish to apply for more than one candidate please complete the form again. If you have any questions, please call us on +44 (0)1509 215172 or email fairfield.admissions@lsf.org Candidate's DetailsLegal Surname* Legal Forename(s)* Preferred Forename/Known As Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender of Candidate Boy Girl Nationality* Is English the candidates first language* Yes No First Language* Please note any previous experience in learning a Modern Foreign Language as well as how many years your child has studied each language.English Language – Level of AttainmentIELTS TRF Certificate No. CEFR Other School YearYear of Entry* Current Year Group (If applicable) Year Group applying for (please tick): Kindergarten Reception Yr1 Yr2 Yr3 Yr4 Yr5 Yr6 Kindergarten: Full time Part time: 4 days Part time: 3 days If part time is required, please indicate preferred days: Monday Tuesday Wednesday Thursday Friday Preferred start date* DD slash MM slash YYYY Names of close relatives at, or having attended, Loughborough Schools Foundation, their relationship to candidate and school attended.Additional CommentsCurrent School/Nursery DetailsName of Current School/Nursery Name of Head/Nursery Manager Address of School/NurseryPostcode Email Address of Current School/Nursery Date Joined Current School/NurseryDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920As part of our standard Admissions policy for applicants to Reception through to Year 6, Fairfield would like to contact your child’s current school or setting for a reference. Please indicate whether you give consent for this below. Yes No Parent/Legal Guardian DetailsParent Legal/Guardian 1Title* Forename(s)* Surname* Relationship to candidate* Address* Street Address Address Line 2 City County Postcode Home Phone*Mobile PhoneEmail Address* Occupation* Employer* Add additional parent/legal guardian? Yes Parent Legal/Guardian 2Title* Forename(s)* Surname* Relationship to candidate* Is your address the same as above? Yes Address* Street Address Address Line 2 City County Postcode Home Phone*Mobile PhoneEmail Address* Occupation* Employer* Where parents have separated or divorced, please state with which parent the candidate resides. Medical detailsPlease provide details of any medication your child requires, disability, medical condition or allergies your child has, or may have, of which the School should be made aware.Learning Support / SEN needsPlease provide details of any learning support / SEN needs e.g dyslexia, dyspraxia, ADD, ADHD, Autistic spectrum disorder (including Asperger's Syndrome) or if your child is being assessed for any of these conditions.If you wish to attach any supporting reports/documentation you may do so here.For example an educational psychologist's report, medical report, occupational therapist's report, please give brief details on a separate sheet and attach a copy of the most recent report. Drop files here or Select files Accepted file types: jpg, png, doc, docx, Max. file size: 12 MB. Entrance Exam Access ArrangementsA candidate who is eligible may be given appropriate adjustment in relation to entrance assessments, subject to documentary evidence being provided. Therefore, if the candidate has had a specialist assessment diagnosing a learning difficulty or disability, for example an educational psychologist’s report, medical report, occupational therapist’s report, please provide details in the boxes above and attach a copy of the most recent report. If the candidate suffers from any medical condition or physical incapacity of which we should be aware, please provide details in the Medical Details box above.Please indicate here if you wish to discuss further. Yes Further DetailsPlease use this space to provide any further details relative to any matter about which you feel we should be aware.Registration Fee £50 per candidatePlease tick here to show you have read and understood the above. Note; if your child is already registered at The Nursery, you are not required to pay an additional Registration Fee.* Please tick here to show you have read and understood the above. Note; if your child is already registered at The Nursery, you are not required to pay an additional Registration Fee. Registration Fee £50 per candidate (non-returnable) Payment options: Payment can be made either by Bank Transfer using the details below, by Cheque (payable to Loughborough Schools Foundation) or click to pay by Credit Card: Loughborough Schools FoundationCurrent a/c no. 08171610Sort Code 601410IBAN: GB86 NWBK 6014 1008 1716 10SWIFT CODE: NWBK GB 2LReference: FDRF and the candidate's surnameI have made Payment by: Bank Transfer Cheque Credit Card Date payment was sent / madeDay12345678910111213141516171819202122232425262728293031Month123456789101112Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920HiddenSchool email Data ProtectionI understand that information from this form may be processed for purposes by Loughborough Schools Foundation under the Data Protection Act 2018 and that individuals have, on written request, the right of access to personal data held about them. For the purposes of compliance with the Data Protection Act 2018, in completing and submitting this form I hereby give my consent to Loughborough Schools Foundation to process the personal and sensitive data supplied in the Registration Form for the purposes of administering its lists of prospective pupils.* Please tick here to show you have read and understood the above. Please verify