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EXCELLENCE IN EDUCATION

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Registration

This the form for you to register your child. Use it to get in touch with us and let us know what your concerns for your child may be. Please be as informative as possible, so that when we call you back we can suggest the best possible ways for your child to maximise thier potential. For more than one child, please fill out separate forms.

Firstname Surname

Address Postcode

Child's Date of Birth Month Year

Daytime Telephone Number

Home Telephone Number

Moblie Telephone Number

E-mail Address

Please state your enquiry in the space below and tick the relevant box(es).

Primary/Prep Programme SAT Programme Pre-GCSE Programme GCSE Programme Scholarship/Admission Programme A-level Programme IB Programme Admissions from Abroad Undergraduate Programme Post-graduate Programme

For details of voluntary contributions, please contact Aunty Ann – eieprogramme@gmail.com.

CURRENT SCHOOL

PROPOSED/DESIRED SCHOOL

Enquiry: Subjects for which your child need assistance. Include Tier/board if known.

Where did you hear of EIE?

Your Child’s Hobbies

Your Child’s favourite TV Character

Your Child’s favourite Cartoon Character

Your Child’s favourite Football team

We wish to acknowledge the payment of a fee of £ for registration on EIE Saturday Sessions 2006/7 and a month of 4 sessions

I give permission for the child named above to attend the EIE Saturday Sessions 2007/8. I agree, to the best of my knowledge that the information supplied on this form is correct.

I give permission as the parent/carer, for the photograph(s) of the child named on this form to be used in future EIE Publications and publicity material. I understand that there will be no payments for the use of my child’s image

Filled By Mr/Miss/Mrs/Dr/Rev

I have read the Terms and Conditions and agree to abide by them.