Loughborough High School This form is for applications to Loughborough High 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 212348 or email firstname.lastname@example.org Candidate's DetailsLegal Surname*Legal Forename(s)*Preferred Forename/Known AsDate of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Nationality*First Language*Year of Entry*Current Year Group (If applicable)*Names of close relatives at, or having attended, Loughborough Schools Foundation, their relationship to candidate and School attended.Year Group Applying For (please tick)*Year Group:*Year 12Additional CommentsCurrent SchoolName of current School*Name of Head*Address of School*Postcode*Email Address* Date joined current School*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Parent/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.Access ArrangementsIf 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 give brief details in the Further Details section on the previous page 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 give details in the Further Details section.Please indicate here if you wish to discuss further. Yes If you wish to attach any documentation you may do so here. Drop files here or Accepted file types: jpg, png, doc, docx, pdf, . 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 give brief details on a separate sheet and attach a copy of the most recent report. If the candidate suffers from any medical or physical incapacity of which we should be aware, please five details below.Medical or physical conditionA Level Subjects:Loughborough High School recommends students take three subjects to A Level. In exceptional circumstances some students may take four A Level subjects, following discussion with the Head of Sixth Form or Assistant Head - (Curriculum). In addition, physical education and enrichment activities form part of the curriculum for all Sixth Form students. The latest Sixth Form option choices booklet (follow the link on the Sixth Form Admissions page of the www.lsf.org/high website) should be studied before completing this section. Please select three options and list them below. If you wish to discuss taking a fourth subject please refer to this in your Personal Statement.’123Predicted GradesPlease list grades for any GCSE exams or equivalent already taken and predicted grades for those to be taken.Personal StatementThe student should use the space below to write a short statement about themselves describing, for example, involvement in extra-curricular activities both in and outside schoolPlease use this space to provide further details relating to any question or other matter about which you feel we should be aware.ScholarshipsThe Music Scholarship programme is now closed to new applications for the academic year 2020-2021. Applications for Music Scholarships should be made directly to the Music department. Further details, including the deadline for applications, are available on www.lsf.org/high. Music Scholarship auditions are held in the January preceding the September of proposed entry to the School.Please indicate here if you intend applying for a Music Scholarship. Yes School Assisted Places (SAPS)The Foundation has funds available to provide financial support towards the tuition fees for those on low incomes. Parents/Legal Guardians who indicate on this form that they wish to be considered for means tested financial support will be sent a Statement of Financial Circumstances Form which must be completed and returned together with the relevant supporting documentation. The award verification process will include a home visit.I have read and understood the above and wish to apply for a means tested Foundation School Assisted Place. Yes Further DetailsData 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. Registration Fee £100 per candidatePayment can be made either by bank transfer using the following details or by cheque (payable to Loughborough Schools Foundation): Loughborough Schools FoundationCurrent a/c no. 08171610 Sort Code 601410Reference: HSRF and candidate's surnameBank Transfer I have paid by bank transfer Date payment was madeDay12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Cheque I have paid by cheque Date cheque was sent or delivered to schoolDay12345678910111213141516171819202122232425262728293031Month123456789101112Year202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920School emailSchool telephonePlease verifyPhoneThis field is for validation purposes and should be left unchanged. 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