Registration Form

Candidate's Details

Candidate's surname *

Candidate's given name(s) *

Please give their full name(s) as stated on their birth certificate/passport.
Please be aware that the name provided is what will appear on examination certificates.

Preferred name

Date of birth *

Boarder or day pupil *

Boarder
Day

Gender *

Male
Female

Please let us know if there is any information relating to the candidate's gender that we should be aware of

Nationality *

First language *

Ethnic category *

Ethnic details: White *

English, Welsh, Scottish, Northern Irish or British
Irish
Gypsy or Irish Traveller
Any other White background

Ethnic details: Mixed or Multiple ethnic groups *

White and Black Caribbean
White and Black African
White and Asian
Any other Mixed or Multiple ethnic background

Ethnic details: Asian or Asian British *

Ethnic details: Black, African, Caribbean or Black British *

African
Caribbean
Any other Black, African or Caribbean background

Ethnic details: Other *

Arab
Any other ethnic group

'Other' ethnic group

As you selected 'any other ethnic group', please let us know which ethnic group the candidate belongs to.

Candidate's religion

Please specify if you have any religious requirements/considerations that we should be aware of.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Enquirer's Details

Enquirer's name (in full) *

Do you have parental responsibility? *

Yes: main/sole responsibility
Yes: shared/equal responsibility with contact(s) listed below
No responsibility

Title *

Relationship to candidate *

'Other' title

As you selected 'other', please specify your title.

'Other' relationship to candidate

As you selected 'other', please specify your relationship to the candidate.

Profession *

Address of enquirer (if different from above)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Mobile phone *

Additional Contact(s)

Please list EVERYONE who has parental responsibility.

Name in full of additional contact *

If you don't have an additional contact, please contact our admissions team before proceeding.

Level of parental responsibility (additional contact 1) *

Yes: main/sole responsibility
Yes: shared/equal responsibility with enquirer and/or other contact(s)
No parental responsibility

Title (additional contact 1) *

Relationship to candidate (additional contact 1) *

'Other' title (additional contact 1) *

As you selected 'other', please specify your title.

'Other' relationship to candidate (additional contact 1) *

As you selected 'other', please specify your relationship to the candidate.

Profession (additional contact 1) *

Address of additional contact 1 *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email (additional contact 1) *

Mobile (additional contact 1) *

Name in full of second additional contact (if applicable)

Level of parental responsibility (additional contact 2) *

Yes: main/sole responsibility
Yes: shared/equal responsibility with enquirer and/or other contact(s)
No parental responsibility

Title (additional contact 2) *

Relationship to candidate (additional contact 2) *

'Other' title (additional contact 2) *

As you selected 'other', please specify your title.

'Other' relationship to candidate (additional contact 2) *

As you selected 'other', please specify your relationship to the candidate.

Profession (additional contact 2) *

Address of additional contact 2 (if different from child's address)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email (additional contact 2) *

Telephone (additional contact 2) *

Mobile (additional contact 2)

Name in full of third additional contact (if applicable)

Level of parental responsibility (additional contact 3) *

Yes: main/sole responsibility
Yes: shared/equal responsibility with enquirer and/or other contact(s)
No parental responsibility

Title (additional contact 3) *

Relationship to candidate (additional contact 3) *

'Other' title (additional contact 3) *

As you selected 'other', please specify your title.

'Other' relationship to candidate (additional contact 3) *

As you selected 'other', please specify your relationship to the candidate.

Profession (additional contact 3) *

Address of additional contact 3 (if different from child's address)

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email (additional contact 3) *

Telephone (additional contact 3) *

Mobile (additional contact 3)

If we should know about any additional people with parental responsibility, please provide their details below.

Further candidate details

Month and year of proposed entry *

e.g., September 2022

School Year at entry *

Do you anticipate that you may require bursary support? *

Yes
No

Click here to find out more about our bursary support available.

Do you already have a child at Wells? *

Yes
No

Name(s) of siblings *

How did you hear about the School? *

Agent details (if applicable)

Name of current school *

Address of current school

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

School telephone

Head / Principal's email contact *

Head / Principal's Name *

Do you give your consent for us to request a reference? *

Yes
No

Please state your reasons for not wanting us to request a reference at this stage. *

When can we contact them for a reference? *

Please note that we are not able to make an offer of a place until the reference has been received.

Please list the academic subjects that your child is studying (please include predicted grades if appropriate)

Please briefly describe your child's interests and hobbies in and out of school

Does your child have any special educational needs our learning support department should be made aware of? *

Yes
No

Please upload any relevant reports if appropriate (e.g., from an educational psychologist or a speech and language specialist)

Click or drag a file to this area to upload.

Please provide any further details about the candidate's special educational needs that we should be aware of.

I understand that should the candidate require any additional 1:1 TA support after joining the School that this will be charged as an additional fee and is not covered under our regular school fees. This is in accordance with our Learning Support and SEND Policy.

Learning Support and Send Policy

Does your child have any medical issues (including mental health, allergies, etc) that we should be aware of? *

Yes
No

Please give details, including any medications. *

Please attach a copy of any EdPsych Report (if applicable)

Click or drag a file to this area to upload.

Are you interested in applying for a Senior School Scholarship?

Yes
No
N/A

Our Scholarship information can be found on our website. Please note that this Registration Form, as well as our separate Scholarship Form, will need to be completed by the stated deadline (typically the first week of term in January).

Are you eligible to apply for a military discount? *

Yes
No

Please upload a photo of the candidate *

Click or drag a file to this area to upload.

Please upload a copy of the candidate's passport *

Click or drag files to this area to upload. You can upload up to 2 files.

Please upload a copy of the candidate's most recent school report *

Click or drag files to this area to upload. You can upload up to 5 files.

Signature *

Date *

Registration Fee *

UK applicants - £ 150.00
Overseas applicants (once this form is submitted, you will receive a message with a link to make this payment) - £ 200.00

Please note your registration will not be complete until we receive your registration payment. This payment is non-refundable.

Please upload a copy of the candidate's parents' passports *

Click or drag files to this area to upload. You can upload up to 4 files.

Please include passports of all parents/guardians with parental responsibility. If the enquirer does not have access to all parents/guardians' passports, please ask them to email a photo of their passport separately to [email protected] along with the candidate's name

Total

£ 0.00

Stripe Credit Card *

Card

Name on Card