Application - Buckswood School

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STUDENT INFORMATION
Application for admission to Buckswood School as a:*
- Full Boarder
- Day Student
- Weekly Boarder
Application for an academy
- Football
- Rugby
- Golf
- Equestrian
- Netball (Girls)
- Futsal (Girls)
Nationality*
First Language*
Date of Birth*
Date Format: DD slash MM slash YYYY
Student Phone*
Student Email*
Place of Birth*
Country*
Student's Surname / Family Name*
First Name*
Middle Name
Please select gender*
- Male
- Female
Current School*
Current Academic Course*
Expected Start Date*
Expected length stay*
Academic Course*
- Junior
- GCSE
- IGGCSE
- A Level
- IB
- UFC
- Short Courses
Your Admissions Representative at Buckswood*
- Samantha Pugh (UK Admissions)
- Olga Nalivkina (International Admissions)
- Cristina Terrazas (International Admissions)
- Yu Hao (Phoenix) (International Admissions)
- Kyoko Field (International Admissions)
- Sherene Zouehid (International Admissions)
- Unsure of the representative in charge
List any ESL qualifications held:*
Does the child require additional help with his or her studies?*
Does the student have any medical issues? If yes, please list these and the medication taken.
Does the Student have any Special Education Needs? If yes, please list any Special Education Needs and support provided/needed for it.
Does the Student have any Behaviour concerns? If yes, please list any Behaviour concerns and support provided/needed for it.
Does the Student have any Safeguarding and Child Protection issues? If yes, please list and support needed for it.
Unreported Medical issues, behaviour concerns and safeguarding and child protection issues: The School reserves the right to ask a parent to withdraw the pupil without being charged fees in lieu of notice if, in the opinion of the School, the School cannot provide adequately for a pupil’s needs should it become apparent that issues were not disclosed fully at the time of application.

FAMILY INFORMATION

Father's Details
Fathers Name*
House Address*
Phone Country Code:*
Number:*
Mobile Country Code:*
Number:*
Father's Email*
Mother's Details
Mother's Details
Mother's Name*
House Address*
Phone Country Code:*
Number:*
Mobile Country Code:*
Number:*
Mother's Email*
Does the child live with both parents?*
- Yes
- No
Whom does he/she live?*
Are the parents separated or divorced?*
- Yes
- No
Who has legal custody?*
Agency Information
Agency Information
Have you used an educational agency?*
- Yes
- No
Agency Name*
Agent Name*
Agent Phone Number*
Agent Email*
Agent Address*
To whom should all correspondence be sent?*
- Mother
- Father
- Agent
- Parents and Agent
To whom should all bills be sent?*
- Mother
- Father
- Agent
- Parents and Agent
Notes regarding billing address*

Additional Information
Additional Information
Was the Child Adopted*
- Yes
- No
At what age?
Does he/she know?
- Yes
- No
Passport Number*
Expiry Date*
Visa Held?*
- Yes
- No
If yes, what type?
Expiry Date
Previously refused a visa?*
- Yes
- No
If yes, why?
It is a condition of entry to Buckswood School that children without a parent resident in the UK must delegate parental responsibility to a suitable local Guardian.

A Guardian or Guardian Agency must be appointed before an international student enters Buckswood School, irrelevant of the age of the student. The selection of a Guardian is the parent’s responsibility.

Parents who reside outside of the UK are expected to complete our Guardian Form which provides the school with full details of the Guardian before the arrival of the student to the school

While a child is with his/her Guardian, the parent – not the school – is responsible for his/her welfare. Buckswood students often use St. George’s Guardians, a highly recommended local guardian company - details of which can be found here: stg-guardians.co.uk AEGIS (Association for the Education and Guardianship of International Students) can provide you with a list of reliable local guardianship agencies, as necessary. www.aegisuk.net

Parents are expected to inform the school if there are any changes to any details relating to the Guardian.
Do you wish to use St. George’s Guardians scheme?*
- Yes
- No
If no, AEGIS (Association for the Education and Guardianship of International Students) can provide you with a list of reliable local guardianship agencies, as necessary. Parents will provide the school with full detail of the guardian that they have appointed before the arrival of the student to the school.

All APPLICANTS TO COMPLETE

(I have read and agree to the Terms and Conditions on the Buckswood website)
I have read and accept the Terms and Conditions*
- Accept Terms and Conditions
https://www.buckswood.co.uk/admissions/terms-and-conditions/
I have read and agree to the Terms and Conditions- Father's Signature
I have read and agree to the Terms and Conditions- Mother's Signature

EMERGENCY CONTACTS

Please list in order of priority your emergency contacts from 1 to 5 (Number 1 being the first priority)
Emergency Contact 1*
Please do not choose the same answer for emergency contacts.
Emergency Contact 2*
Please do not choose the same answer for emergency contacts.
Emergency Contact 3*
Please do not choose the same answer for emergency contacts.
Emergency Contact 4*
Please do not choose the same answer for emergency contacts.
Emergency Contact 5*
Please do not choose the same answer for emergency contacts.
Notes if other, please provide: Name and Surname, relation with student, phone, email and address*

Data Security
If you grant us permission to share your child's data with your named guardian and/or the named individual within your agency, in line with our T&C's, please complete the below.
Do you give permission for this data to be given?*
- I grant permission to share my child's data with the named guardian and/or the named individual within the agency
- I do NOT grant permission to share my child's data with the named guardian and/or the named individual within the agency
Name of the Pupil*
First Last
Your nominated named guardian and/or named indivudal within your agency
Age of the student*
- Under 13 years old
- 13 Years old or over
Email address of named guardian or individual within your agency*
Student Signature (13 or over)*
Parent/Guardian Signature*
Please sign below to confirm that the information entered is correct and that you accept the Terms and conditions (https://www.buckswood.co.uk/admissions/terms-and-conditions/).
Date Signed*
Date Format: DD slash MM slash YYYY
Consent*
I agree to the privacy policy.
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