Bursary Application Form - Christ's Hospital

Home & Background Form

We are delighted that you are applying for a place at Christ’s Hospital.

You have indicated to us that you would like to apply for bursary assistance. Bursary funds are limited and are assessed not only on the financial information you supply, but also the need for a boarding education.

In the following Home and Background form, it is important that you give us as much information as possible about the need of a boarding education. All relevant questions/sections of the form must be fully completed. If information is found to be missing or unsupported, the Admissions Team may ask for further information/documentation, to support the information given on the form.

Failure to complete this form by your assigned date will mean that even if your child sits the Initial Assessments, we will not be able to consider them for bursary assistance.

Should you have any queries regarding your application, we would be delighted to help:

For Year 7 Girls and all Sixth Form applications – please contact Debbie Nye

E: dn@christs-hospital.org.uk | T: 01403 247797

For Year 7 Boys and all Year 9 applications – please contact Jodie Hewitt

E: jrh@christs-hospital.org.uk | T: 01403 247409

Applicant's details

Applicant’s name (as appears on their birth certificate)*

First name(s)*

Middle name(s)

Surname*

Date of birth*

Year group at entry to Christ’s Hospital*

Year of entry to Christ’s Hospital*

Parent/Guardian details

Details of adult(s) with whom the applicant currently lives.

First adult details*

First adult (mother / father / other, please specify)*

First Adult (mother / father / other, please specify)*

Please specify the relationship of the first adult to the applicant:*

Title*

First name*

Last name*

Please enter your title*

Address*

Is this your only address?*

If ‘NO’ please detail on the income verification page at the end of this form

Email address*

Home Telephone*

Work Telephone

Mobile Telephone*

Occupation**

Does your job involve working anti-social hours/shift work?*

Please give further details of your anti-social working hours/shift work:*

Are there any other adults with whom the applicant currently lives with, apart from the one listed above?*

Yes

No

Second adult (mother / father / other, please specify)*

Second Adult (mother / father / other, please specify)*

Please specify the relationship of the second adult to the applicant:*

Second adult details*

Title*

First name*

Last name*

Please enter your title*

Does the second adult live at the same address as the first adult (as detailed above)?*

Yes

No

Address*

Is this your only address?*

If ‘NO’ please detail on the income verification page at the end of this form

Home Telephone*

Work Telephone

Mobile Telephone*

Occupation**

Does your job involve working anti-social hours/shift work?*

Please give further details of your anti-social working hours/shift work:*

Social/Family circumstances

Please tell us about the applicant's social/family situation, for example, any domestic circumstances that may prevent the applicant from meeting their academic potential, which have not been previously indicated in this form.

E.g. difficult relationship with a separated parent, lack of other family support, previous traumatic incident.

As a family, have you received, or are you currently receiving, support from Social Services?*

Yes

No

If you are happy to, please share details in the box below:

Special circumstances

Are there any other special circumstances you wish to draw to our attention, which are not already mentioned above?*

Yes

No

If 'YES', please give further details:*

Declaration*

I/We understand that:

The information given on this form is correct and complete to the best of our knowledge and belief. The School reserves the right not to proceed with an application for a bursary where the information required is either not forthcoming, found to be false or is intentionally misleading.

The School reserves the right to request any document they deem necessary to support the information provided in making this application.

The application must be signed by those adults resident in the household where the applicant lives.

Each parent/legal guardian to digitally sign their name. If you are divorced or separated from the applicant’s natural parent, the Admissions Office require written permission for the application from the ex-spouse/partner in all cases of joint responsibility by provision of two signatures at the end of this application, or by a separate letter from the estranged parent.

Declaration of first parent / guardian*

Enter the full name above of the first parent / guardian, with whom the applicant resides, as your digital signature.

Date of digital signature for first parent / guardian*

Date of digital signature for first parent / guardian

Declaration of second parent / guardian

Enter the full name above of the second parent / guardian, with whom the applicant resides, as your digital signature.

Date of digital signature for second parent / guardian

Date of digital signature for second parent / guardian

Consent*

I confirm I have read the bursary and admissions policies.

Consent*

I understand that Christ’s Hospital will only use this information for the purposes of admission administration. If you would like more information about how we store and use your personal data, please see our Privacy Notice. Alternatively we can send you a copy of the Privacy Notice – please contact our Data Protection Officer, Christ’s Hospital, Horsham, West Sussex RH13 0YP

Overview

School Life

Information