Student Application Form

A1 Student Application
STUDENT DETAILS
(Appendix A)
Student Name
Student Name
First Name
Family Name
Gender

Please select the course you wish to attend. The fully inclusive fee per student (excluding travel) is listed below course selection: *
PARENT/GUARDIAN DETAILS
Home mailing address (Please fill in ALL lines/fields - type n/a if Not Applicable)
Home mailing address <i>(Please fill in ALL lines/fields - type n/a if Not Applicable)</i>
City
State/Province
Zip or Postal code
Country
A copy of this Application Form will be sent to this address.
Alternative contacts in case of emergency
We always try to reach parents first; in case we cannot reach you please give different contact details to the ones listed above.
CHOOSE ONE STUDY CHOICE
Study choices
Please note:
You will be asked to provide an assessment of your child’s ability at English or Spanish, if you have selected these, at a later date.
CHOOSE ONE CLUB CHOICE
Club choices

Please let us know

If this application is made via an agency, please complete the agent information below:
STUDENT HEALTH SECTION
(Appendix B)
Your application requires this medical form to be completed. Full disclosure of information is expected. All information will be treated in confidence and only shared with those who have direct responsibility for the care and well-being of the child. Should external medical support be required, some of this information may be required by the hospital and doctor.

Here is a link to our Coronavirus Information.
Is the student registered with a Doctor in the UK?
Special Dietary Requirements or Disorders
Has the student experienced any of the conditions mentioned below? (Please tick all boxes that apply.)

Please provide details of all regular medication taken by the student. Please note that ALL medication brought to the School MUST be shown to your child's House Parent.

Please provide details of your child's Tetanus immunisation history.

Medication is administered ONLY when strictly necessary and by qualified nurses or senior staff. These medications can be obtained from a pharmacy in the UK without requiring a prescription. If there are any medications from the following which cannot be given to your child, please advise
PAIN RELIEF: Paracetamol
PAIN RELIEF: Ibuprofen
ANTIHISTAMINE: (e.g. Chlorpheniramine, Cetirizine)

Consent and Signature

I understand that, in an emergency, every effort will be made to obtain my consent prior to an operation and/or the administration of an anaesthetic.
However, should the school be unable to contact me, I hereby give my authorisation for the Director or Deputy Director to consent on my behalf.
Please confirm that you agree to Gordonstoun International Summer School retaining this personal data in compliance with the School's current GDPR policy,
and that we may use this information as necessary to process this application.
Please confirm that you have read, understood and agree to to the Gordonstoun International Summer School Terms and Conditions.
I hereby certify that I have given, to the best of my knowledge, full and correct information about my child's physical & psychological health.
Name of Parent/Guardian completing this form
Name of Parent/Guardian completing this form
First
Last