REGISTRATION FORM Easter Holidays 2018

Size: px
Start display at page:

Download "REGISTRATION FORM Easter Holidays 2018"

Transcription

1 REGISTRATION FORM Easter Holidays 2018 To register a place: Please complete in capitals all sections and return with payment to our holiday schools team on summer@windermereschool.co.uk. 1. Student Details Surname:. First Name:.. Female Date of birth: Male Day.. Month.. Year.. Age on 2 April 2018 (Min Age 8):.. Current Windermere School Pupil? If no, please specify school name and location:.. 2. Contact Details 3. Medical and Dietary Information Parent or Guardian Name For pupils studying at Windermere School, please tick if you would like to use the contact details on the school system: Address:... Town:... Postcode:... Home Telephone:... a) Does your child have a medical condition? b) Does your child have any allergies? c) Is your child taking any medication? d) Does your child require a special diet? If you have answered yes to any questions please attach details to the registration form as necessary. Work Telephone:... Windermere Educational Trust Limited is a Registered Charity Registered Office: Browhead Windermere

2 4. Which course(s) would you like to book? Dates Times Cost Watersport Tuesday 3 to Friday 6 April Monday 9 to Friday 13 April 9.00am to 12.45pm 9.30am to 12.30pm 170 Sailing 170 Sailing Please tick course(s) Please state RYA Sailing Level (if known) Windermere Educational Trust Limited is a Registered Charity Registered Office: Browhead Windermere

3 5. Parental Consent (1) I give consent for my son/daughter to travel short journeys in the school s minibuses if required. (2) I give permission for the summer school to use photographs of my son/daughter in future marketing material; digital and print, including Facebook. (3) It is important to realise that there is a small degree of risk in all activities, which will be managed to the lowest level possible by appropriate staffing. I consent to my son/daughter participating in all activities, and those that are deemed a suitable alternative due to external constraints such as weather and group ability. Student s Name:.... I hereby give full consent for the above child, as detailed within this Parental Consent Form. Signed Parent/Guardian:.. Date:... Windermere Educational Trust Limited is a Registered Charity Registered Office: Browhead Windermere

4 6. Terms and Conditions of Registration Agreement The completion and signing of this Registration Form forms an agreement that the student will follow and adhere to all the terms and conditions it contains. Behaviour If the student behaves in any way deemed unacceptable by the Course Manager, Windermere International Summer School reserves the right to send the student home immediately, with no refund of fees. In respect to damages, caused deliberately or as a result of inappropriate behaviour, Windermere International Summer School will recover costs from the parents or guardians of the child or children involved. Insurance Except where required by the terms of its own insurance cover, Windermere International Summer School does not accept liability for damages, injuries, illnesses or other claims related to students unless such liability is legally imposed. Medical We accept students only on the understanding that they are in good health. The Medical and Dietary information allows you to give us an insight in to your child s health and dietary needs, but we can take no responsibility for any aspects not included. Please give a full account in writing if there are any additional concerns or matters about which we need to know. Changes to the programme The course has been planned and published in good faith. Windermere International Summer School reserves the right, however, to make any changes to the programme or cancel the course if it is deemed necessary. Adverse weather In the event of adverse weather (strong winds, rough water or no wind) Windermere International Summer School reserves the right to alter from the watersports scheme syllabus to appropriate indoor activities. These will aim to relate to watersports, however where this is not possible other team work, communication and skills development activities will take place. 7. Agreement It is important that the Terms and Conditions have been read and understood before signing below. I confirm that all the information contained within sections 1 5 is correct. I confirm that I accept the terms and conditions of registering my son/daughter. Name... Relationship Date Signature PLEASE TURN OVER FOR PAYMENT DETAILS Windermere Educational Trust Limited is a Registered Charity Registered Office: Browhead Windermere

5 Payment Form One week Sailing Course = Total Payment = Payment Options a) Sterling Cheque Payable to Windermere Educational Trust Limited b) Credit Cards (Visa/Mastercard/Visa Electron) & UK Debit Cards (Switch/Maestro) Please contact the School on or complete the following: Please select: Credit Card Debit Card Signature Date. 16 or 19 digit number Expiry Date Security Windermere Educational Trust Limited is a Registered Charity Registered Office: Browhead Windermere

Red House Account details are: Sort Code Cash will only be accepted for a late booking during a holiday club period.

Red House Account details are: Sort Code Cash will only be accepted for a late booking during a holiday club period. Holiday Club Booking Conditions 1. Places will only be allocated upon a fully completed booking form with an indication of how the cost is to be paid. Confirmation of your booking will follow and payment

More information

Happy Nursery Day Terms & Conditions

Happy Nursery Day Terms & Conditions Happy Nursery Day Terms & Conditions REGISTRATION To reserve a place for your child, you must complete and return your application form; pay an administration fee of 30- your cheque must be made out to

More information

Government Bursary Scheme

Government Bursary Scheme Chelmsford County High School Government 16-19 Bursary Scheme 2015 2016 The Government 16 19 Bursary Scheme is intended to assist students to continue in full time education, and will be managed internally

More information

STUDENT HOMESTAY APPLICATION FORM 2017

STUDENT HOMESTAY APPLICATION FORM 2017 APPLICANT DETAILS (Please complete all sections) Family Name:... Given Names: English Name:.... Gender: Male Female Country of Birth:. Date of Birth:. / / Day Month Year Nationality on Passport: Passport

More information

August 19-24, 2014 (Tuesday-Sunday)

August 19-24, 2014 (Tuesday-Sunday) What is EDGE Adventure Camp? A five day Catholic camp with sports & activities including canoeing, kayaking, giant rope swing, water sports and more! Live music, catechesis, Mass, praise & worship and

More information

Junior High Registration

Junior High Registration St. Angela Merici Catholic Church Junior High Ministry (714) 529-1821 Ext. 147 2012-2013 Junior High Registration Welcome! The Junior High Ministry program is open to any family registered in our parish.

More information

STEPPING STONES APPLICATION FORM

STEPPING STONES APPLICATION FORM STEPPING STONES APPLICATION FORM Childs Name Name Known By Date of Birth Full Address Including Postcode. Male/Female Start Date Please Note: If both parents/carers with (Full Parental Responsibility)

More information

2019 SCHOLARSHIP APPLICATION FOR M. Late applications will not be accepted. Please address all applications and enquires to:

2019 SCHOLARSHIP APPLICATION FOR M. Late applications will not be accepted. Please address all applications and enquires to: 2019 SCHOLARSHIP APPLICATION FOR M SPORTS SCHOLARSHIP St Paul s Scholarships are awarded to those who are most able to demonstrate their capacity to make an exceptional contribution to the School community

More information

REGISTRATION FORM 2018

REGISTRATION FORM 2018 STUDENT: REGISTRATION FORM 2018 *Please note registrations are accepted on a first come first served basis. All sections on registration form must be completed. PARENT/GUARDIAN: Date of Birth: (yyyy/mm/dd)

More information

Health and social care mock trial what s your verdict?

Health and social care mock trial what s your verdict? Health and social care mock trial what s your verdict? IOSH Health and Social Care Group event in conjunction with Speakers Darren McDonald Chair, IOSH Health and Social Care Group An international law

More information

EQI Holiday Adventure Programs - Supervisor Expression of interest form

EQI Holiday Adventure Programs - Supervisor Expression of interest form EQI Holiday Adventure Programs - Supervisor Expression of interest form Privacy Statement EQI is collecting the information on this form to assess your expression of interest to be an EQI Holiday Adventure

More information

Occupational health prevention and control

Occupational health prevention and control Occupational health prevention and control event 09.30 16.10 www.iosh.co.uk/foodanddrinkgroup Event information 09.30 16.10 Preventing work-related ill health through the design and delivery of an effective

More information

November Dear Parents. Duke of Edinburgh s Award Scheme Bronze Award

November Dear Parents. Duke of Edinburgh s Award Scheme Bronze Award November 2017 Dear Parents Duke of Edinburgh s Award Scheme Bronze Award The Duke of Edinburgh s Award Scheme is a nationally recognised scheme promoting personal development which is extremely well regarded

More information

APPLICATION FOR A YACHT RATING CERTIFICATE FOR Ratings on Commercially and Privately Owned Yachts and Sail Training Vessels of Less Than 3000gt

APPLICATION FOR A YACHT RATING CERTIFICATE FOR Ratings on Commercially and Privately Owned Yachts and Sail Training Vessels of Less Than 3000gt MSF 4340 / REV 0508 APPLICATION FOR A YACHT RATING CERTIFICATE FOR Ratings on Commercially and Privately Owned Yachts and Sail Training Vessels of Less Than 3000gt IMPORTANT - BEFORE completing this form,

More information

AORERE COLLEGE ENROLMENT FORM

AORERE COLLEGE ENROLMENT FORM AORERE COLLEGE ENROLMENT FORM YEAR 2017 For students in Year 10 Section 1 Student Details Male / Female (please circle) Email Address: Present /Previous School s Other Names Used Ethnic/Cultural Groups

More information

Managing and monitoring occupational health and wellbeing

Managing and monitoring occupational health and wellbeing Managing and monitoring occupational health and wellbeing IOSH South Coast Branch joint event with IOSH Thames Valley Branch www.iosh.co.uk/southcoastbranch Event information The are delighted to confirm

More information

ENROLMENT FORM. for VACATION CARE. You must answer all questions please print & use a black or blue biro

ENROLMENT FORM. for VACATION CARE. You must answer all questions please print & use a black or blue biro ENROLMENT FORM for VACATION CARE You must answer all questions please print & use a black or blue biro You ll need to fill in separate forms for each child Child s Surname First Name Child s CRN Is this

More information

Glastonbury YMCA 29 Welles Street, Glastonbury CT Dear YMCA Family,

Glastonbury YMCA 29 Welles Street, Glastonbury CT Dear YMCA Family, s Dear YMCA Family, Thank you for choosing the Glastonbury Family YMCA Preschool for your early childhood child care needs. We are excited to welcome you and your family to our program! The Y s focus is

More information

November Dear Parents. Duke of Edinburgh s Gold Award

November Dear Parents. Duke of Edinburgh s Gold Award November 2017 Dear Parents Duke of Edinburgh s Gold Award I am writing to offer the opportunity for committed participants to complete The Duke of Edinburgh s Award at Gold level at Tadcaster Grammar School

More information

July Loyalist Week. July Military Week. Child's Name: Male/Female/Other: Date of Birth: Medicare #: Expiry: Home Address:

July Loyalist Week. July Military Week. Child's Name: Male/Female/Other: Date of Birth: Medicare #: Expiry: Home Address: 2018 Summer Camp Registration Forms Payable with cheque, cash, or email money transfer (Please contact the office for more details). Make cheques payable to the York Sunbury Historical Society. Refunds

More information

Application for: Short Programme. Nelson Mandela Metropolitan University: 20. Prog. 1. Name: Prog. 2. Name:

Application for: Short Programme. Nelson Mandela Metropolitan University: 20. Prog. 1. Name: Prog. 2. Name: Please attach a recent passport size photograph of yourself Application for: Short Programme Prog. 1. Name: Prog. 2. Name: Nelson Mandela Metropolitan University: 20. SURNAME INITIALS STUDENT NUMBER For

More information

Recognition of Environmental Health qualifications obtained overseas

Recognition of Environmental Health qualifications obtained overseas Recognition of Environmental Health qualifications obtained overseas Application for registration as an Environmental Health Practitioner (EHP) (Non EU) PLEASE COMPLETE THIS FORM IN BLOCK CAPITALS OR ELECTRONICALLY

More information

Register for Mini U today

Register for Mini U today Register for Mini U today Register your child for their favorite program early. There are a limited number of spaces available, so send in your registration before they fill up! Registration start dates

More information

Esperance Senior High School Student Enrolment Form

Esperance Senior High School Student Enrolment Form Esperance Senior High School Student Enrolment Form Section 1: Surname Pink Lake Road, P O Box 465, ESPERANCE WA 6450 Phone: (08) 9071 9555 Fax: (08) 9071 9556 Junior Campus Phone: (09) 9071 9503 Email:

More information

U.S. Army Aeromedical Research Laboratory Gains in the Education of Mathematics and Science Program PARTICIPANT APPLICATION

U.S. Army Aeromedical Research Laboratory Gains in the Education of Mathematics and Science Program PARTICIPANT APPLICATION To be considered for acceptance into the 2013 GEMS program, submit the following: 1. The Participant Application 2. The Participant Essay 3. The Participant Release Form 4. Participant Safety Information

More information

Application form. Notice of intention to manage the financial affairs of a resident and application for Certificate of Authority

Application form. Notice of intention to manage the financial affairs of a resident and application for Certificate of Authority Notice of intention to manage the financial affairs of a resident and application for Certificate of Authority For care service providers or limited registration services Application form August 11 - Version

More information

Background The ONE Bus Scheme Cost for using the scheme Administration Current One Bus Scheme routes... 3

Background The ONE Bus Scheme Cost for using the scheme Administration Current One Bus Scheme routes... 3 Background... 1 The ONE Bus Scheme... 1 Cost for using the scheme... 2 Administration... 2 Current One Bus Scheme routes... 3 Appendix A - Code of Conduct... 4 Appendix B - Application Form... 5 Appendix

More information

APPLICATION FORM. Please note that completion of this form and an interview does not imply automatic acceptance. Toddler (2 3 yrs)

APPLICATION FORM. Please note that completion of this form and an interview does not imply automatic acceptance. Toddler (2 3 yrs) 82 Pitzer Road, Glen Austin, Midrand, Gauteng, SOUTH AFRICA P.O. Box 119, Linbro Park, 2065, Gauteng, SOUTH AFRICA Telephone: (+27) 11-314-2744 Fax: (+27) 86-671-7281 Telephone: (+27) 11-608-1584/2206

More information

Bus Travel Assistance Safety-Net Application cont... 4 Names of students applying for bus travel assistance IMPORTANT: Student details must match reco

Bus Travel Assistance Safety-Net Application cont... 4 Names of students applying for bus travel assistance IMPORTANT: Student details must match reco DTMR Code The information on SN the tear off page must be read before completing this form. Section A - to be completed by parent/guardian 1 Bus Travel Assistance Safety-Net Application School Transport

More information

EQUINE PROGRAM SUMMER VOLUNTEER APPLICATION HOME PHONE: T-SHIRT SIZE (circle one): SMALL MEDIUM LARGE X-LARGE XX-LARGE

EQUINE PROGRAM SUMMER VOLUNTEER APPLICATION HOME PHONE: T-SHIRT SIZE (circle one): SMALL MEDIUM LARGE X-LARGE XX-LARGE EQUINE PROGRAM SUMMER VOLUNTEER APPLICATION VOLUNTEER NAME: BIRTH DATE: / / MAILING ADDRESS: CITY: STATE: ZIP: CELL PHONE: HOME PHONE: EMIAL ADDRESS: T-SHIRT SIZE (circle one): SMALL MEDIUM LARGE X-LARGE

More information

WOODBRIDGE HIGH SCHOOL P r i d e I n A c h i e v e m e n t

WOODBRIDGE HIGH SCHOOL P r i d e I n A c h i e v e m e n t 16-19 BURSARY SCHEME INTRODUCTION: Welcome to Woodbridge High School. This booklet provides you with important information about the 16-19 BURSARY FUND. The Bursary is split into two parts; Major and Minor

More information

2016 Child Enrolment Form

2016 Child Enrolment Form Child Outside School Hours Care 2016 Child Enrolment Form Service St Rose Outside School Hours Care 8 Rose Avenue, Collaroy Plateau NSW 2097 Phone: 0407 316 875 Email: collaroy.oshc@dbb.org.au Website:

More information

Georgetown Police Department 2018 Junior Police Academy Application

Georgetown Police Department 2018 Junior Police Academy Application Georgetown Police Department Application Application Deadline: Friday, April 27, 2018 by 5:00pm. There are 25 slots available for each camp, so don t delay in turning in your application. Applications

More information

Nurse Prescribing Summit 2018

Nurse Prescribing Summit 2018 Nurse Prescribing Summit 2018 10% 15% card payments discount* Group booking discount** Monday 19 February 2018 De Vere West One Conference Centre, London For a 20% Discount Quote hcuk20svn Speakers Include:

More information

green volunteers 2018

green volunteers 2018 www.greenteam.org.uk the green team green volunteers 2018 green volunteers Holiday Activity Programmes offer outdoor environmental activities and nature exploration in stunning countryside locations. Monday

More information

BANGOR REGION YMCA CHILDCARE REGISTRATION FORM

BANGOR REGION YMCA CHILDCARE REGISTRATION FORM On-Site Registration Required BANGOR REGION YMCA CHILDCARE REGISTRATION FORM Childcare Information & Program Attending - Please Print ( )Early Childhood Education ( )Y-Works ( )Before School ( )After School

More information

Superintendent s Regulation 4400-R Exhibit 1

Superintendent s Regulation 4400-R Exhibit 1 Superintendent s Regulation 4400-R Exhibit 1 School Field Trip Planning Form Instructions All information on this form must be completed before presenting the form for approval to the Principal, School

More information

ST PIUS X SCHOOL. Enrolment Application Form

ST PIUS X SCHOOL. Enrolment Application Form ST PIUS X SCHOOL Cnr Ley Street & Cloister Avenue, Manning, WA 6152 Phone (08) 9450 2797 Fax (08) 9313 2317 Website: www.stpiusx.wa.edu.au Email: admin@stpiusx.wa.edu.au Enrolment Application Form Calendar

More information

APPLICATION PACK BURJ DAYCARE NURSERY

APPLICATION PACK BURJ DAYCARE NURSERY APPLICATION PACK BURJ DAYCARE NURSERY Child s Name: This application form must be fully completed and the necessary documents provided before a child can start at nursery. Child s Details Child s name:

More information

American Mock World Health Organization 2015

American Mock World Health Organization 2015 American Mock World Health Organization 2015 18th June, 2015 Dear Delegates, Observers, and Faculty, It is with great pleasure that we welcome you to the second American Mock World Health Organization

More information

Student T-shirt size is: Small Medium Large XLarge 2XLarge 3XLarge (Circle one)

Student T-shirt size is: Small Medium Large XLarge 2XLarge 3XLarge (Circle one) Participant Permission Form/ Release Waiver Form My child,, has my permission to attend. I understand this celebration is offered to all graduates who have signed and maintained both the Project Grad Participant

More information

Summer Day Camp Registration 2018 Pierce County School Based Day Camps YMCA OF PIERCE AND KITSAP COUNTIES

Summer Day Camp Registration 2018 Pierce County School Based Day Camps YMCA OF PIERCE AND KITSAP COUNTIES Summer Day Camp Registration 2018 Pierce County School Based Day Camps YMCA OF PIERCE AND KITSAP COUNTIES Completed registration is due the Wednesday prior to first day of camp. Return registration to

More information

Mindfulness Yoga & Meditation Retreat Registration July 15-21, 2019

Mindfulness Yoga & Meditation Retreat Registration July 15-21, 2019 Mindfulness Yoga & Meditation Retreat Registration July 15-21, 2019 Please fill out a separate registration form for each participant. A $100 non-refundable deposit is required and will be applied to your

More information

Springfield Police Department

Springfield Police Department PLEASE NOTE: Applications will be accepted beginning May 15, 2018, and the deadline for applications will be June 20, 2018. Press Release Chief of Police John P. Cook has announced the dates for the 2018

More information

REGISTRATION FORM ST. BERNADETTE S FAMILY RESOURCE CENTRE

REGISTRATION FORM ST. BERNADETTE S FAMILY RESOURCE CENTRE REGISTRATION FORM ST. BERNADETTE S FAMILY RESOURCE CENTRE ST. JUDE S ACADEMY OF THE ARTS Telephone: (416) 740-7187 Application Date: Withdrawal date: Date of Entry: MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY

More information

Enrolment Form - Domestic

Enrolment Form - Domestic Please complete ALL areas of this form. This form can be completed digitally or neatly using blue or black pen. Please note that we are unable to finalise your enrolment until all required information

More information

VOLUNTEER APPLICATION PACK for under 18 year olds

VOLUNTEER APPLICATION PACK for under 18 year olds SALFORD DIOCESAN PILGRIMAGE TO LOURDES, 2015 VOLUNTEER APPLICATION PACK for under 18 year olds Dear Parents / Guardians Thank you for allowing your child to take part in the Diocesan Pilgrimage to Lourdes

More information

Parent/Guardian Names: Cell Phone: School: Parent/Guardian Signature: Date:

Parent/Guardian Names: Cell Phone: School: Parent/Guardian Signature: Date: SPIRIT OF AMERICA BOATING SAFETY PROGRAM Offered by Sailing Center Chesapeake & St. Mary s College of Maryland Open to students who have completed 6 th, 7 th, or 8 th grades in 2017. Summer 2017 Student

More information

Application for Enrolment YOUNG ADULT STUDENT Student Name

Application for Enrolment YOUNG ADULT STUDENT Student Name Application for Enrolment YOUNG ADULT STUDENT Student Name Please complete all sections. An incomplete application will result in a delay in processing and your form may be returned to you to complete.

More information

VOLUNTEER APPLICATION

VOLUNTEER APPLICATION VOLUNTEER APPLICATION Name: Age: Date of Birth: Social Security : Address: City: State: Zip Phone: Work: Cell: Email Address: How can we reach you? Home phone Cell phone Text Email Work phone Employer/School:

More information

INDIANA UNIVERSITY GLOBAL GATEWAY FOR TEACHERS REGISTRATION FOR OVERSEAS STUDENT TEACHING

INDIANA UNIVERSITY GLOBAL GATEWAY FOR TEACHERS REGISTRATION FOR OVERSEAS STUDENT TEACHING INDIANA UNIVERSITY GLOBAL GATEWAY FOR TEACHERS REGISTRATION FOR OVERSEAS STUDENT TEACHING 1 - Placement Information Sheet Record all dates as month (spell out), day, and year. First and last name: Birth

More information

Tacolneston & Morley CE VA Primary Schools Federation

Tacolneston & Morley CE VA Primary Schools Federation Tacolneston & Morley CE VA Primary Schools Federation Educational Visits and School Trips Policy All policies at Tacolneston & Morley CE VA Primary Schools Federation should be taken as part of the overall

More information

TEXAS. Technology Students Association FORMS

TEXAS. Technology Students Association FORMS TEXAS Technology Students Association FORMS 2017-2018 1: Texas TSA Protest Form. Please note that protest for NQE Entries MUST use the National TSA Protest Form Form found below and in the National TSA

More information

Practice Incentives Program Indigenous Health Incentive and Pharmaceutical Benefits Scheme Co-Payment Measure Patient Registration and Consent

Practice Incentives Program Indigenous Health Incentive and Pharmaceutical Benefits Scheme Co-Payment Measure Patient Registration and Consent Practice Incentives Program Indigenous Health Incentive and Pharmaceutical Benefits Scheme Co-Payment Measure Patient Registration and Consent Purpose of this form Patient registration Complete Part A

More information

GENERIC RISK ASSESSMENT FOR ALL DERBY CITY SCHOOL SPORTS PARTNERSHIP ACTIVITIES

GENERIC RISK ASSESSMENT FOR ALL DERBY CITY SCHOOL SPORTS PARTNERSHIP ACTIVITIES 31 August 2014 The aim of this generic risk assessment is to provide general information on the type of hazards employees, pupils and others who attend the activities could be exposed to. This document

More information

London Karate dō Shōtō Association Membership Application Form

London Karate dō Shōtō Association Membership Application Form London Karate dō Shōtō Association Membership Application Form Please write in block capitals and in black ink ALL sections must be filled in incomplete forms will be rejected BASIC INFORMATION Last name:

More information

2017 VENTURA COUNTY JUNIOR LIFEGUARD PROGRAM HELD ON SILVER STRAND BEACH IN OXNARD

2017 VENTURA COUNTY JUNIOR LIFEGUARD PROGRAM HELD ON SILVER STRAND BEACH IN OXNARD 2017 VENTURA COUNTY JUNIOR LIFEGUARD PROGRAM HELD ON SILVER STRAND BEACH IN OXNARD Dear Junior Lifeguard Families and prospective Junior Lifeguards: Enclosed is your 2017 PROGRAM OUTLINE. Please retain

More information

Mindfulness Yoga & Meditation Retreat Registration July 20-26, 2015

Mindfulness Yoga & Meditation Retreat Registration July 20-26, 2015 Mindfulness Yoga & Meditation Retreat Registration July 20-26, 2015 Please fill out a separate registration form for each participant. A $100 non-refundable deposit is required and will be applied to your

More information

National PROMs Summit

National PROMs Summit * National PROMs Summit Speakers include: Prof W Angus Wallace Division of Orthopaedic and Accident Surgery University of Nottingham/Nottingham University Hospitals NHS Jonathon Hope MBE Patient & Co-Chair

More information

2017 VolunTeen Application. Fort Belvoir Community Hospital

2017 VolunTeen Application. Fort Belvoir Community Hospital Page1 2017 VolunTeen Application Thank you for your interest in participating in the 2017 Summer VolunTeen Program! The American Red Cross got its start serving the United States Armed Forces and now you

More information

Staffordshire County Council General Risk Assessment Record Form

Staffordshire County Council General Risk Assessment Record Form Staffordshire County Council General Risk Assessment Record Form 1. Section/Service/Team St Paul s First School, Coven 2. Assessor(s) Karen Roberts, Jenny Picken 3. Description of Task/Activity/Area/Premises

More information

Registration Form Parent/Guardian Information:

Registration Form Parent/Guardian Information: Registration Paid $ Entered by: Payment : Initial Visit: Registration Form How did you hear about us? Parent #1 Parent/Guardian Information: First & Last name: Drivers License# Family Password Address

More information

SCHOLARSHIP APPLICATION FORM

SCHOLARSHIP APPLICATION FORM SCHOLARSHIP APPLICATION FORM Scholarship is merit based and is open to bright and needy young men and women joining university in Kenya. PROVIDING FALSE INFORMATION: Providing false information may result

More information

FAMILY CHRISTIAN CENTER SCHOOL BEFORE and AFTERCARE APPLICATION

FAMILY CHRISTIAN CENTER SCHOOL BEFORE and AFTERCARE APPLICATION : FAMILY CHRISTIAN CENTER SCHOOL BEFORE and AFTERCARE APPLICATION Student Please Print Name Grade: Age: Review the following to ensure completion of the application process. Registration fee (due upon

More information

Roosevelt Care Center. Volunteer Service Application

Roosevelt Care Center. Volunteer Service Application Volunteer Service Application Name : : City, State, Zip Code: Home phone #: Cell phone# In Case of Emergency, please notify: Phone # Relationship: of last PPD (Tuberculosis skin test) Have you had: Mumps

More information

Kairos Retreat for Teens [SFK13] September 22, 23, 24 & 25 th, 2016

Kairos Retreat for Teens [SFK13] September 22, 23, 24 & 25 th, 2016 For Juniors & Seniors in High School What is Kairos? Kairos, which means Lord s Time, is a Christian experience of prayer and reflection, run by a team of adults and trained peer leaders. St. Francis de

More information

Application form. Affiliate Delegate. DEADLINE: 22 June Access to Conference Hall

Application form. Affiliate Delegate. DEADLINE: 22 June Access to Conference Hall Application form It s faster and easier to apply online; you can access the application form at: www.labevents.org/ac2018affiliatedelegate Before you start Affiliate Delegate Access to Conference Hall

More information

East Baton Rouge Parish Junior Deputy

East Baton Rouge Parish Junior Deputy East Baton Rouge Parish Junior Deputy 2018 Application Packet Sheriff Sid J. Gautreaux, III Captain Randy M. Aguillard Program Director raguillard@ebrso.org Junior Deputy Membership Rules All members of

More information

Registering as a dentist with the General Dental Council (EU/EEA/Switzerland)

Registering as a dentist with the General Dental Council (EU/EEA/Switzerland) www.gdc-uk.org Registering as a dentist with the General Dental Council Application Form This application form, accompanying documents and registration fee should be posted to: Registration Team (New Registrations)

More information

Huntington University Nursing Career Academy Application Process Summer 2015

Huntington University Nursing Career Academy Application Process Summer 2015 Application Process Eligibility Requirements: applicants must be in 10 th, 11 th, or 12 th grade during the 2014-2015 academic school year and be interested in exploring a career in nursing. Program cost:

More information

Grant Application Form

Grant Application Form Grant Application Form Please complete as fully as possible Please note cannot provide items for use in school/college If returning the form by post, it should be hand signed, if being sent via e-email

More information

Rio Norte Junior High School Music Department Rio Norte Drive, Valencia, CA PH X 1505

Rio Norte Junior High School Music Department Rio Norte Drive, Valencia, CA PH X 1505 Festival and Disneyland Tour PARTICIPANT COMMITMENT CONTRACT I,, hereby commit and guarantee that (Parent or legal guardian printed name) will travel with the Rio Norte, (Student printed name) to participate

More information

DEMENTIA AND PRIMARY CARE

DEMENTIA AND PRIMARY CARE DEMENTIA AND PRIMARY CARE A ONE-DAY CONFERENCE TUESDAY 24TH OCTOBER 2006 IRIS MURDOCH BUILDING, UNIVERSITY OF STIRLING A one-day conference to explore issues related to supporting people with dementia

More information

FAIRMAN S Skate Shop 2018 Summer Skateboarding Day Camp Programs

FAIRMAN S Skate Shop 2018 Summer Skateboarding Day Camp Programs FAIRMAN S Skate Shop 2018 Summer Skateboarding Day Camp Programs Location: Skatepark at West Goshen Township s Robert E. Lambert Park 1045 Pottstown Pike (Rte 100 at Greenhill Road), West Chester, PA 19380

More information

PROFESSIONAL BABY NURSE SERVICES CONTRACT

PROFESSIONAL BABY NURSE SERVICES CONTRACT PROFESSIONAL BABY NURSE SERVICES CONTRACT PARTIES 1. This Contract agreement is made between: (hereafter referred to as CLIENT ), residing at and (hereafter referred to as BABY NURSE ). EFFECTIVE DATES

More information

Qualification Approval for delivery Level 6 & Interpreter qualifications

Qualification Approval for delivery Level 6 & Interpreter qualifications Qualification Approval for delivery Level 6 & Interpreter qualifications This form is to be completed by all existing IBSL and new centres applying to become approved to deliver IBSL Level 6 programmes,

More information

Corpus Christi Parish Confirmation Registration Checklist

Corpus Christi Parish Confirmation Registration Checklist Corpus Christi Parish Confirmation Registration Checklist Completed Registration Form (required each year) Copy of Baptismal Certificate (if not baptized at Corpus Christi) Student and Youth Activity Permission

More information

School of Nursing and Midwifery Hands on Training Program

School of Nursing and Midwifery Hands on Training Program INTRODUCTION School of Nursing and Midwifery Hands on Training Program The School of Nursing and Midwifery in collaboration with the Department of Health Western Australia, announce the dates for the 2014

More information

Bishop Druitt College Outside School Hours Care

Bishop Druitt College Outside School Hours Care Bishop Druitt College Outside School Hours Care Enrolment Form OSHC Centre 6651 7400 0414 515 606 Fax: (02) 66515654 E-mail: oshc@bdc.nsw.edu.au : 111 North Boambee Road Coffs Harbour NSW 2450 Enrolment

More information

Supporting Parents in Neonatal

Supporting Parents in Neonatal P a g e 1 Start Fundraising For Supporting Parents in Neonatal small acts when multiplied by millions of people can change the world P a g e 2 The Alexa Trust +441304371520 89 Station Road www.thealexatrust.org

More information

Singers ONSTAGE! Registration Form

Singers ONSTAGE! Registration Form Singers ONSTAGE! Registration Form Student Information Full Name City State Zip Home Phone Date of Birth Grade (as of 9/1/15) Gender (circle one): Male Female Each registration includes two T-shirts, professional

More information

OLSH College Bentleigh 2020 Scholarship Information

OLSH College Bentleigh 2020 Scholarship Information OLSH College Bentleigh 2020 Scholarship Information Flame Scholarship The Flame Scholarship will be awarded to students who best demonstrate their lived commitment to the four pillars of Our Lady of the

More information

Vulnerable Student Bursary (for those young people in one of the defined groups (below)

Vulnerable Student Bursary (for those young people in one of the defined groups (below) Beths Grammar School 16-19 Bursary Application Form Academic Year 2017-2018 Prior to completion, please read the Government guidelines at www.gov.uk/guidance/advice-for-young-people-16-to-19-bursary-fund-guide

More information

Application for support from the SOAS Hardship Fund

Application for support from the SOAS Hardship Fund Academic Year 2017/2018 Date of receipt (office use only): Important Application for support from the SOAS Hardship Fund This form to be completed by International and EU students only Your application

More information

225 Williamson Street Elizabeth, NJ Name: Last First. Home Address: City State Zip Code

225 Williamson Street Elizabeth, NJ Name: Last First. Home Address: City State Zip Code 225 Williamson Street Elizabeth, NJ 07207 APPLICATION FOR MEDICAL MENTOR PROGRAM AT TRMC Name: Last First : Home Address: City State Zip Code of Birth: Home Phone: Are you Male or Female? (circle one)

More information

Faith Formation sessions begin the week of September 18 th, 2017

Faith Formation sessions begin the week of September 18 th, 2017 SAINT MAXIMILIAN KOLBE CATHOLIC CHURCH FAITH FORMATION REGISTRATION FORM Faith Formation sessions begin the week of September 18 th, 2017 To register in St. Maximilian Kolbe Faith Formation program the

More information

Year of admission applied for: Grade in entering: ST JOSEPH S SCHOOL BOULDER

Year of admission applied for: Grade in entering: ST JOSEPH S SCHOOL BOULDER CHILD S SURNAME: CHILD S NAME: Year of admission applied for: Grade in entering: ST JOSEPH S SCHOOL BOULDER Please include the following with your application $20 Application Fee Birth Certificate Baptism

More information

THE ICPAK ACCOUNTING & FINANCE SCHOLARSHIP

THE ICPAK ACCOUNTING & FINANCE SCHOLARSHIP THE ICPAK ACCOUNTING & FINANCE SCHOLARSHIP Creating Pathways to Achievement Passport size photos APPLICATION FORM - 2017 The Scholarship is merit-based and is open to bright and needy young men and women

More information

Reaching Higher Harvard Summer School 2018 Scholarship

Reaching Higher Harvard Summer School 2018 Scholarship Reaching Higher Harvard Summer School 2018 Scholarship Application Form Please ensure you read the Application information document before you start filling in this form. If you have any questions regarding

More information

Form 11 Residential Field Study Trip in Sierra de Gredos

Form 11 Residential Field Study Trip in Sierra de Gredos Form 11 Residential Field Study Trip in Sierra de Gredos Dear Parents, Monday 20 th April 2015 It is proposed that the Science and Humanities Departments will be running a residential field study visit

More information

EMERGENCY CONTACT INFORMATION LIST ALL OTHER ADULTS YOU AUTHORIZE CONNECT STAFF TO RELEASE YOUR CHILD TO:

EMERGENCY CONTACT INFORMATION LIST ALL OTHER ADULTS YOU AUTHORIZE CONNECT STAFF TO RELEASE YOUR CHILD TO: AFTER SCHOOL PROGRAM Fall Spring CHILD PERSONAL DATA SHEET Child s DOB Home Address City State Zip Gender School Enrolled in: : Employer Email : Employer Email Work APP Requested Work APP Requested EMERGENCY

More information

NOTES OF GUIDANCE. To be eligible for transport in September a pupil must have attained the age of 4 years on or before 1 st July.

NOTES OF GUIDANCE. To be eligible for transport in September a pupil must have attained the age of 4 years on or before 1 st July. Application for Transport Assistance in respect of attendance at PRIMARY SCHOOL Please read carefully prior to completion of form. Detach and retain for your own reference. NOTES OF GUIDANCE ELIGIBILITY

More information

CAMP AT THE EASTWARD A Youth Ministry of Mission at the Eastward

CAMP AT THE EASTWARD A Youth Ministry of Mission at the Eastward CAMP AT THE EASTWARD A Youth Ministry of Mission at the Eastward Dear Camper and Family, We are welcoming some changes to the camp schedule this year! In an effort to allow our dedicated work groups to

More information

2007 SUMMER VOLUNTEEN PROGRAM APPLICATION PACKET

2007 SUMMER VOLUNTEEN PROGRAM APPLICATION PACKET 2007 SUMMER VOLUNTEEN PROGRAM APPLICATION PACKET The complete application is due back to the Human Resources department at Baptist South no later than the end of day on Monday, April 23 rd. Baptist Medical

More information

Affordable Concierge New Patient Registration

Affordable Concierge New Patient Registration Affordable Concierge New Patient Registration Patient Information Last name: First name: MI: DOB: [ ] Male [ ] Female Home address: City: State: Zip: Billing address: [ ] Same as home City: State: Zip:

More information

EDUCATIONAL VISITS POLICY

EDUCATIONAL VISITS POLICY AIM/PURPOSE EDUCATIONAL VISITS POLICY The aim is twofold; to ensure that the visit planned is a valuable and worthwhile experience which will add to the social and educational development of students,

More information

INDIANA UNIVERSITY GLOBAL GATEWAY FOR TEACHERS. Tips for the Registration Set (December 2017)

INDIANA UNIVERSITY GLOBAL GATEWAY FOR TEACHERS. Tips for the Registration Set (December 2017) INDIANA UNIVERSITY GLOBAL GATEWAY FOR TEACHERS Tips for the Registration Set (December 2017) NOTES: These tips do not replace a thorough reading of the Global Gateway Program Booklet! Before you prepare

More information

1) INFORMATION ABOUT THE PARTICIPANT AND ACTIVITY

1) INFORMATION ABOUT THE PARTICIPANT AND ACTIVITY 2016-17 South Carolina 4-H Membership and Event Permission Form for Youth (Updated 08.01.16) ALL elements of this form must be completed by youth participating in clubs, field trips, events requiring group

More information

Home Address City State Zip. ( ) Parent/Guardian First Name Last Name Home Phone Number. Home Address City State Zip ( ) Cell ( )

Home Address City State Zip. ( ) Parent/Guardian First Name Last Name Home Phone Number. Home Address City State Zip ( ) Cell ( ) GREENKNOLL SCHOOL AGE CHILD CARE 2018-2019 School Year Fees due at the time of registration: $25 Registration Fee + First Week s Tuition Weekly tuition rates listed on payment sheet Child s First Name

More information

4-H HEALTHY LIVING RETREAT OCTOBER 13 TH -15 TH. Learn about careers & other opportunities in the healthy living field!

4-H HEALTHY LIVING RETREAT OCTOBER 13 TH -15 TH. Learn about careers & other opportunities in the healthy living field! Learn about careers & other opportunities in the healthy living field! Attend workshops on trending topics in Healthy Living! OCTOBER 13 TH -15 TH 4-H HEALTHY LIVING Take the 500 Mile Challenge, and participate

More information