Place

photograph
here

Application for admission

Student details 

First name................................................................................................ Surname............................................................ Gender M F

Date of birth............................................................................................ Place of birth..........................................................................................
Nationality............................................................................................... First language........................................................................................
Mobile number....................................................................................... Skype ID.................................................................................................
Address..........................................................................................................................................................................................................................
........................................................................................................................................................................................................................................
Passport number..................................................................................... Expires on......................................... UK visa held? Yes No
For all visa nationals, please email us a scanned copy of your passport photo and visa page.
Have you ever been refused a UK Visa? Yes No (if ‘yes’, provide date and reasons for refusal).
Earlscliffe may reject and report any application that it believes to contravene UKVI regulations.

Parent details 

Father’s name.......................................................................................... Father’s email.........................................................................................

Father’s phone number.......................................................................... Father’s mobile number........................................................................
Father’s address.............................................................................................................................................................................................................
........................................................................................................................................................................................................................................
Mother’s name......................................................................................... Mother’s email.......................................................................................
Mother’s phone number........................................................................ Mother’s mobile number......................................................................
Mother’s address (if different).....................................................................................................................................................................................
........................................................................................................................................................................................................................................
Address for fees invoices to be sent to (if different from above)............................................................................................................................
Does the child live with both parents? Yes No
If ‘no’, with which parent does the child normally reside and does this parent have legal custody?.................................................................

Guardianship 

For students who are under 18 on commencing their studies, we require an adult UK resident to be nominated as a guardian who will
act for overseas parents in representing their son or daughter. The school can provide a guardianship service for a termly fee.
Details of nominated guardian in the UK
Name........................................................................................................ Email.......................................................................................................
Phone number........................................................................................ Mobile number......................................................................................
Address..........................................................................................................................................................................................................................
OR I would like Earlscliffe to provide a guardianship service

Agent details 

Have you used the service of an educational agent or counsellor? Yes No (if ‘yes’, please provide details below)
Name of agency...................................................................................... Name of your contact...........................................................................
Phone number........................................................................................ Email.......................................................................................................
Previous school details (if enrolled less than two years then list other schools on a separate sheet)

School name............................................................................................ School email..........................................................................................

Address..........................................................................................................................................................................................................................

Dates of attendance................................................................................ Level of qualifications attained, ie GCSE...........................................

English language qualifications 

IELTS overall score....................................................................................................................... Date taken.........................................................

Other English qualifications....................................................................................................... Date taken.........................................................

Date of entry requested (tick one)

September 20.... January 20.... April 20....

Course choice 

A-level ITY / 1 year GCSE University Foundation Year English for Academic Purposes

A-level subject choices (see A-level subject options form - sixthform.earlscliffe.co.uk/resources)

Block A ....................................................................................................................................................................................................................
Block B ....................................................................................................................................................................................................................
Block C ....................................................................................................................................................................................................................

Addtional choices (see schedule of fees for additional costs)

Block D ...................................................................................................................................................................................................................
Native Language (most non-native speakers will study their own language) .........................................................................
IELTS (compulsory for non-native speakers who do not have a GCSE English qualifcation) .........................................................................

List your interests outside school

(sports, music, art, dance, chess, volunteer work... and any personal achievements, awards, prizes etc you may have gained in recent years)

........................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................

University aims (possible degree subject area and any universities you may wish to apply to)

........................................................................................................................................................................................................................................
........................................................................................................................................................................................................................................

Payment details
I agree to pay a non-refundable registration fee and refundable deposit upon submission of this application form. For methods of
payment, please see the schedule of fees form.

Please state your preferred method of payment: credit card bank transfer cheque

Parent agreement
I agree to all the Terms & Conditions and policies as published on the Earlscliffe website (www.earlscliffe.co.uk).

Father’s signature........................................... Mother’s signature......................................... Student’s signature............................................

Date................................................................. Date................................................................. Date....................................................................

Earlscliffe T +44 (0)1303 253951 Earlscliffe is an independent

sixth form college.
29 Shorncliffe Road E [email protected] Earlscliffe is part of Sussex
Folkestone, CT20 2NB www.earlscliffe.co.uk Summer Schools Limited,
United Kingdom registered in England
no. 4091830