Scholarship Entry Form

I apply for my son q daughter q ward q to be entered for the following Scholarship:

Academic (7+, 9+, 11+) q Music (9+, 11+) q Art (11+) q Drama (11+) q Sport (11+) q

Name of Candidate in full: (in capitals) __________________________________________

Date of Birth: ____________________ Present Year Group: ________________________
Internal Candidate q Class: ____________________________________________

External Candidate q Name of School: ____________________________________

Address of School: ___________________________________
___________________________________________________

School Telephone: ___________________________________

If successful would you like your child to enter as a:

Day Pupil q Weekly Boarder q Full Boarder q

For External Candidates, would you like your child to be considered for a place in the School even if he/she is unsuccessful in gaining an award?

Yes q No q

Please provide any information which you feel may be useful to this application (e.g. Music grade results, Sporting successes, Academic prizes/results.)

___________________________________________________________________________

Name and address of parent/guardian: ___________________________________________

__________________________________________________________________________

Profession (Father): __________________________________________________________

Profession (Mother): __________________________________________________________

Home Telephone: _____________________________

Business Telephones (Father): ___________________ (Mother): ______________________

Signed: _____________________________ Date: ______________________ 20_______

Please complete and return to the Headmaster at Lichfield Cathedral School.