APPLICATION FORM Type of Registration * Which type of course are you registering for? Full Time Non-Boarding Day Student (UK Citzens Only) Full Time Boarding Short Stay Programme (2 Terms Max) Educational Agents * Is this form being completed by an educational agent? Yes No Agency Details If Applicable Student Name * Student's Full Name (Including Middle names) Religion * Enter the student's religion Nationality * Language Student's primary language Date of Birth * MM DD YYYY Passport Number Required for International Students Primary Parent Name * First Name Last Name Daytime Phone Number * Country (###) ### #### Evening Phone Number * Country (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Relationship to Student * Does the Student Reside With You? * Yes No Second Parent & Guardian For International Students I acknowledge that Just Football will follow up to request the details of a second parent and a UK based guardian. Whilst these are not required as part of the registration, they will be required in order to offer a place as they are a strict visa requirement. I understand Current/Most Recent School * We need these details to obtain academic and pastoral reports School Address * Address 1 Address 2 City State/Province Zip/Postal Code Country School Email * Date of Attendance (From and To) * Medical and Other Needs * Does the student have any medical or special educational needs? Yes No Details if Yes Declaration * I/we request that our child named in this registration be submitted for Application to the Just Football International Academy. I/we understand that submitting this form does not constitute an offer of a place. I/we understand that Just Football may collect personal and sensitive information about ourselves and our child such as medical information, financial details such as credit agreements and court orders as well as educational reports from previous schools. I/we consent to this information being gathered and processed for the express and sole purpose of a place being offered as well as for the ongoing safeguarding of our child. Agree Loco Parentis * Please read and note carefully the following: In a case of necessity your child will receive National Health Service (NHS) medical attention. Confidential medical information is only divulged to relevant staff on a strictly need to know basis. In normal circumstances when an anaesthetic or operation is necessary the consent of the parent or guardian will first be obtained. In an emergency, when a parent or guardian cannot be contacted, I give consent for the Head or in his absence his designated Deputy to act in loco parentis. I accept, in the best interests of my child, the terms in which I have read the above and will advise the School of any change in the student's medical condition or treatment. I agree to the terms and conditions set out within this application I Agree Thank you for registering your child. We will be in touch shortly if we require any further information.
