GRAMMAR SCHOOLS’ CENTRAL REGISTRATION FORM

For entry to Year 7 in September 2016 for any of the Gloucestershire Grammar Schools PLEASE COMPLETE IN BLOCK CAPITALS Pupil’s details

Legal Surname:

Other Names:

Date of Birth:1 Gender: M / F

Present School: (inc address & postcode) Postcode: Pupil’s permanent home address / main residence: (the address where the child permanently lives or lives for the majority of the time. Where a child lives with both parents on an equal basis, both parents must agree which of their addresses to use))

Postcode: 1A pupil’s date of birth must be between 1st September 2004 and 31st August 2005 to be eligible to sit the test in September 2015. If the pupil’s date of birth is out of this range, you will need to contact the individual school(s) to discuss the process – see overleaf for contact details.

Parent(s) /Carer(s) details

Parent/Carer 1 Parent/Carer 2

Title & Initials:

Surname:

Relationship to pupil:

Telephone Home:

Mobile:2

Telephone Work:

2 Please provide a mobile phone number, this information will be required on the test day should you need to be contacted.

Email Address for test results:

(Please ensure this email is accessible outside of working hours)

Although completing this registration form on paper, would you like to receive Yes No further information regarding the test, and your son’s/daughter’s results by email?

Pupils will usually sit the entrance test at their preferred grammar school. Please indicate at which grammar school your child will sit the entrance test (Test Centre) so that the school can make the appropriate arrangements: (please be aware that this Test Centre cannot be changed after submitting the form)

Test Centre (Name of School):

(This choice should be relevant to the gender of the school’s intake, see table overleaf) Your child’s test results can be shared with up to four Gloucestershire Grammar Schools to be considered for entry. Please select below (PTO) those Grammar Schools you would like to consider your child’s results. (Requests for shares are not in preference order). One of these choices must be the Test Centre you have chosen. Excessive sharing complicates the results process for parents so please only share with Grammar Schools that you would realistically consider your child attending.

Child in Public Care Pupil Share In receipt of Free 3 Schools or previously 3,4 Premium result with 3,4 School Meals (including chosen Test Centre) (please tick) looked after child (please tick if appropriate) (The Crypt (please tick if appropriate) only) High School for Girls, Denmark Road, , (Boys)

Pate’s Grammar School, Cheltenham (Mixed)

Ribston Hall High School, Gloucester (Girls)

Sir Thomas Rich’s School, Gloucester (Boys)

Stroud High School, Stroud (Girls)

The Crypt School, Gloucester (Boys)

3 Further information is available in the Gloucestershire Grammar Schools’ Admissions Information booklet available on the schools’ websites 4 Evidence/supporting documentation must be supplied to the Test Centre prior to sitting the test.

The Test Centre needs to know if your child has any special educational needs, medical conditions, disabilities or other factors for consideration which might require reasonable adjustments to be made to the testing process, please outline these below. A supplementary form will be sent to you for completion:

Please note that it is the parents’/carers’ responsibility to ensure the supporting evidence is provided to the Test Centre when requested by 12 noon Friday 3 July 2015.

I/We have parental responsibility for the above named child. If NOT, The parent/carer has given permission for me/us to complete the form on their behalf (tick to confirm) I/We certify that the above information is correct. I/We wish my/our child to be registered to sit the ENTRANCE TEST on the morning of SATURDAY 12 SEPTEMBER 2015. I/We agree to supplying a photograph of my/our child for the Test Day ID Form and bringing it on the day of the Test. I/We hereby grant permission to the school to share with the University of Durham and any third party directly involved in the testing process, any personal information contained herein. In addition I/We also grant the University of Durham permission to subsequently share this personal information with any other school performing similar testing for any reason deemed necessary by the University in order to ensure the integrity of the test. I/We understand that giving false or intentionally misleading information will mean the withdrawal of the offer of a school place. I/We understand that this registration form only applies to the seven Gloucestershire grammar schools. If you want test results to be shared with any other grammar school you MUST complete the registration process for that school.

Parent’s/Carer's Signature:

Please ensure that you also complete your Local Authority’s Online Common Application Form by the closing date, usually 31st October 2015 (after you have received your child’s entrance test results).

TEST CENTRES: Cheltenham Pate’s Grammar School, Princess Elizabeth Way, Cheltenham, Glos, GL51 0HG (Mixed) Tel: 01242 538238 Gloucester High School for Girls, Denmark Road, Glos, GL1 3JN (Girls) Tel: 01452 543335 , Stroud Road, Glos, GL1 5LE (Girls) Tel: 01452 382249 Sir Thomas Rich’s School, Oakleaze, Glos, GL2 0LF (Boys) Tel: 01452 338400 , Podsmead, Glos, GL2 5AE (Boys) Tel: 01452 530291 Stroud Marling School, Cainscross Road, Stroud, Glos, GL5 4HE (Boys) Tel: 01453 762251 , Beards Lane, Stroud, Glos, GL5 4HF (Girls) Tel: 01453 764441

PLEASE RETURN TO YOUR CHOSEN TEST CENTRE BY 12.00 NOON ON FRIDAY 3 JULY 2015 PROOF OF POSTING CANNOT BE ACCEPTED AS PROOF OF DELIVERY