Application Form

Student Application
STUDENT DETAILS
Student Name
Student Name
First Name
Family Name
Gender
Please select which two subjects you wish to revise during the course *
subjects
Please fill in the relevant information about your chosen subjects, if known
EXAM BOARD
Mock exam grade (if known)
Predicted grade
PARENT/GUARDIAN DETAILS
Home mailing address <i>(please fill in all fields - type n/a if not applicable)</i>
City
State/Province
Zip/Postal
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.

For Gordonstoun Parents Only:
If your child is unable to return home and requires accommodation between the end of the course and the start of term, please indicate here (there will be an additional charge for this).
I require weekend accomadation

STUDENT HEALTH SECTION
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.

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.)

Section

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.

Section

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 to consent on my behalf.
Please confirm that you agree to Gordonstoun Active Revision 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 Active Revision 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