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Registration Form

We hope you would like to register your child for a place at Broomfield. Children can be registered from birth. For Pre-Kindergarten, the first to register will join our Main List, which means they are guaranteed the offer of a place. After that, and for entry to all other year groups, we run a Waiting List. Registration cannot guarantee the offer of a place.

All registrations require a registration fee of £100 per child (non-returnable) payable by bank transfer (details below) or by cheque payable to Broomfield House School Ltd.

HSBC UK BANK Plc

Account Name	Broomfield House School Ltd
Account Number	21260324
Sort Code	40-11-60
Branch Name	City Of London
IBAN	GB78HBUK40116021260324
SWIFTBIC	HBUKGB4B

Child's First Name *

Child's Middle Name(s)

Child's Last Name *

Layout

Child's Date of Birth *

Gender *

Male
Female

Child's Nationality *

Proposed Year of Entry *

Parent / Guardian 1 Title *

Parent / Guardian 1 First Name *

Parent / Guardian 1 Last Name *

Parent / Guardian 2 Title

Parent / Guardian 2 First Name

Parent / Guardian 2 Last Name

Home Telephone Number

Parent / Guardian 1 Mobile Number *

Parent / Guardian 2 Mobile Number

Parent /Guardian 1 Email Address *

Parent /Guardian 2 Email Address

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is your child currently attending a school or nursery, or will they be attending a school or nursery prior to joining our school? *

Address of current and/or previous nursery or school *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Does your child have any dietary requirements? *

Does your child have any medical or learning needs? *

Siblings (Please also show their Date of Birth)

How did you hear about our school? *

GDPR Consent

Email
Phone

We take your privacy seriously and will only use your personal information to provide the services you have requested from us. However, from time to time we would like to contact you with further information. if you consent to us contacting you for this purpose please tick to say how we can do so.

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