Application for Entry

Pupil

Pupil’s Surname:* Forenames in full:* Preferred name (if applicable) Date of birth:*

Sex*MaleFemale

Parent / Guardian

1

Title* First name Last name

2

Title* First name Last name

Full address of Parents/Guardian

Address (line 1) Address (line 2) Town / City Postcode

Contact

Please complete appropriate fields

	Father	Mother	Guardian
Telephone (Home)
Telephone (Work)
Mobile
Email
Occupation
Religious denomination
Nationality

Family connections with the School (if any): For separated parents only, please indicate with whom child is living:

Previous Education

School(s) attended during the last two years (a reference will be requested): Name of Head: Month and year of entering Month and year of entering Please indicate if you wish your child to be considered for entry in September 2020 Please upload PUPIL’S BIRTH CERTIFICATE No file chosen Please indicate how you first heard of Leicester Grammar Junior School:*

Payment

I will send the registration fee of £50.00 (non-refundable) (cheques to be made payable to LEICESTER GRAMMAR SCHOOL TRUST)*Please tick to confirm

Use the link below to make an online payment for the non-returnable registration fee of £50 and a copy of the named child's full birth certificate uploaded below.

Registration Fee Payment Link

Leicester Grammar Junior School

Leicester Grammar School Trust

Leicester Grammar School