Application form for International School Wassenaar

1 STUDENT INFORMATION ACCORDING TO HIS/HER PASSPORT

Family Name of Student

First Name(s)

Gender
femalemale

Date of Birth (dd-mm-yy)

Place of Birth

Country of Birth

Nationality(ties)

Required Entrance Date

BSN Number

Middle Name

Preferred Name:

Mother Tongue

Language(s) spoken at home

Main written language(s)

Expected length of stay in NL

2 CORRESPONDENCE ADDRESS

Address

Postal Code

Phone

E-mail

City, Country

Mobile Phone

Fax

3 STUDENT’S ADDRESS DURING THE PERIOD AT THE INTERNATIONAL SCHOOL OF WASSENAAR

Address

Postal Code

Phone

E-mail

City, Country

Mobile Phone

Fax

4 SIBLINGS - NAME, AGE, ENROLLED IN WHICH SCHOOL

Name

Age

School

Name

Age

School

Name

Age

School

6 PARENTS/GUARDIANS CONTACT DETAILS (|)

Family Name

First Name

Phone

E-mail

Company Name

Address

City

Phone

Mobile Phone

Relationship to student

Nationality

Mobile Phone:

Date and place of birth

Occupation

Postal Code

Country

Fax

E-mail

7 PARENTS/GUARDIANS CONTACT DETAILS (||)

Family Name

First Name

Phone

E-mail

Company Name

Address

City

Phone

Mobile Phone

Relationship to student

Nationality

Mobile Phone:

Date and place of birth

Occupation

Postal Code

Country

Fax

E-mail

8 OTHER CONTACT DETAILS

If parents are divorced or separated please indicate legal guardian for your child:

Address

Postal Code

Phone

E-mail

City,Country

Mobile Phone

9 EDUCATIONAL INFORMATION

Name of current school

Name of contact person

Address of current school

City

Phone

E-mail contact person

Postal code

Country

Please note: It is school policy to contact the current/previous school of a student applying to study at the International School Wassenaar. By signing this application form you give your permission to the Admissions officer to contact your child’s current/previous school.

10 SCHOOL HISTORY (including pre-school)

1 Name of School

1 Language of Instruction

1 Grade

1 School Year

1 Diploma/Certificate

2 Name of School

2 Language of Instruction

2 Grade

2 School Year

2 Diploma/Certificate

3 Name of School

3 Language of Instruction

3 Grade

3 School Year

3 Diploma/Certificate

11 LEARNING SUPPORT

Has your child received support in the following areas? (Please include all formal testing/reports)

English as an additional language
Speech & Language Therapy
Behaviour & Social Skills

Reading & Spelling
Enrichment & Extension
Concentration & Organisational Skills

Mathematics
Other

Please comment on anything else that would assist us in working with your child:

13 ADMISSIONS REQUIREMENT

Please be aware that an application will not be processed for admission unless the application form has been fully completed and all supporting documents, listed below, have been received by the Admissions Office

CHECKLIST:
A completed application from
Photocopy of passport of applicant
Passport size photograph of applicant
Copies of academic records for the current and 2 previous school years (English)
Formal testing/report on learning support

Photocopies of passport of applicant.
Passport size photograph of applicant.
Copy of academic records of the current school year.
Copy of academic records of previous school year. (1)
Copy of academic records of previous school year. (2)
Formal testing/report on learning support.(1)
Formal testing/report on learning support.(2)

14 HOW DID YOU HEAR ABOUT US?

15 SIGNATURE

- I hereby certify that all information and documents provided with this application is accurate, true and complete and understand that provision of faulty or insufficient information can lead to a reversed admissions decision.
- The International School Wassenaar reserves the right to withdraw an offer of admission (or exclude the student) from the International School Wassenaar at any future date in the event that the information provided is not accurate of important information regarding the student has not been disclosed or has been withheld.
- It is school policy to contact the current/previous school of a student applying to study at the International School Wassenaar. By submitting this application form you give your permission to the Admissions officer to contact your child’s current/previous school.
- By signing below I am agreeing that I have read and will abide by the International School of Wassenaar’s Standard Terms and Conditions.

Photo release consent:

School Guides and School Brochures
Digital Newsletter(s)

School Website
School Social Media Accounts (Twitter, Facebook, Flickr)

Signature of Parent/Guardian

Date

Conform de Algemene verordening gegevensbescherming (AVG) verzamelt en verwerkt het Rijnlands Lyceum Wassenaar uitsluitend persoonsgegevens die noodzakelijk zijn voor onze dienstverlening. Bij de verwerking van persoonsgegevens zorgt Rijnlands Lyceum Wassenaar voor beveiliging van de gegevens tegen verlies en onrechtmatige verwerking. Klik hier voor onze privacy policy.

Application – Form

1 STUDENT INFORMATION ACCORDING TO HIS/HER PASSPORT

2 CORRESPONDENCE ADDRESS

3 STUDENT’S ADDRESS DURING THE PERIOD AT THE INTERNATIONAL SCHOOL OF WASSENAAR

4 SIBLINGS - NAME, AGE, ENROLLED IN WHICH SCHOOL

5 YEAR GROUP REQUESTED

6 PARENTS/GUARDIANS CONTACT DETAILS (|)

7 PARENTS/GUARDIANS CONTACT DETAILS (||)

8 OTHER CONTACT DETAILS

9 EDUCATIONAL INFORMATION

10 SCHOOL HISTORY (including pre-school)

11 LEARNING SUPPORT

12 MEDICAL DETAILS

13 ADMISSIONS REQUIREMENT

14 HOW DID YOU HEAR ABOUT US?

15 SIGNATURE