St Mary’s School, Hampstead: Request for a place on the waiting list Registration Section Please complete this form in as much detail as possible. We need this information to be able to process your application. Information which is mandatory for you to provide is indicated by a * Your Child Surname * First Names * Preferred Name * Nationality * Sex * Religion * Date of Birth * Is your child a British or Irish citizen? * YES NO I confirm that my child has the appropriate immigration permission to live in the UK and to study at the School: * Please note that the School does not hold a Child Student sponsor licence and it is your responsibility to ensure that your child has the appropriate immigration permission to live in the UK and to study at the School. We reserve the right to request evidence that your child has such permission prior to their admission to the School. Proposed term and year of entry * Have you registered your child’s name at any other school(s)? * YES NO Other school(s) * First Signatory Title * e.g. Mr, Mrs, Miss, Ms Full name * Relationship to child * Contact telephone number(s) * Email address * Address * Address Address Address City City County or London Borough County or London Borough Postcode Postcode Occupation Employer's business name and address Second Signatory Title * e.g. Mr, Mrs, Miss, Ms Full name * Relationship to child * Contact telephone number(s) * Email address * Address * Address Address Address City City County or London Borough County or London Borough Postcode Postcode Occupation Employer's business name and address If you are human, leave this field blank. Next