1. Child's Details

One of the candidate’s parents/guardians must complete this form.

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* Surname of your child

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* First names: (underline preferred name)

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* Gender:

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* Date of Birth:

Date

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* Current Address:

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* Current School:

I wish for my son/daughter to be entered as a candidate for an Academic Scholarship and I intend that, if successful, he/she will join Uppingham Cairo as a pupil in the Fourth Form (Year 10).

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* Signature (Please print name in full including title and all names):

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* Parent Email Address

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* Parent Mobile 'Phone Number

 
 100% of survey complete.