Please print this form and send by fax or mail, or cut and paste into Word and send by email.

APPLICATION FOR ADMISSION TO HØRSHOLM INTERNATIONAL SCHOOL

Starting date: _______20___                              Expected duration of stay at HIS: _____­­­­­­­­­­­­­____________

                                                         

Applicant:

 

Family name: ____________________       First Name (s): ____________________

Date of birth (D/M/Y): ____________            Sex: ____________________________

Nationality:      ___________________

DK Address:    ________________________________________________________

Post Code:      ___________________       Town:           ­_____________________

DK-Kommune: ___________________       DK-Telephone: ____________________

CPR Number:  ___________________        E-mail:           _____________________

If your child is not a Danish CPR Number holder – are you planning that he/she will be? Yes/No

Home Address: ________________________________________________________

Country:        ___________________       Home telephone: ___________________

Father or Guardian:                       Mother or Guardian:

Name: __________________________      Name: ___________________________

Nationality: ______________________       Nationality: _______________________

Profession/Title: __________________       Profession/Title: ___________________

Company/employer: _______________      Company/employer: ________________

Address of company/employer: ______      Address of company/employer: _______

________________________________      _________________________________

Office Telephone: _________________      Office Telephone: __________________

Office Fax: _______________________     Office Fax: _______________________

Name and age of siblings in the family   ____________________________________

Name of brothers/sisters enrolled at HIS ____________________________________

Please list previous schools attended by the applicant, beginning with the most recent one:

1:         Name of school: _________________________________________________

          Address: _______________________________________________________

          Country: _______________________________________________________

          Language of instruction: ___________________________________________

          Grades/Forms: __________________________________________________

2:       Name of school: _________________________________________________

          Address: _______________________________________________________

          Country: _______________________________________________________

          Language of instruction: ___________________________________________

          Grades/Forms: __________________________________________________

Total years of school completed (excluding pre-school and kindergarten): _________

Family Language/Mother Tongue: __________ Applicant’s best language: ________

Other languages spoken: ________________________________________________

Number of years studying the English language: _____________________________

Has the applicant any medical circumstances the school should be aware of? No/Yes

If yes, which medical circumstances? ______________________________________

Any allergies? No/Yes.  If yes, which allergies? ______________________________

Any physical limitations? No/Yes.  If yes, which physical limitations? ____________

Has the applicant ever required special needs education? No/Yes

If yes, for which learning disabilities has the applicant received which special education services? _____________________________________________________

How many years has the applicant lived in Denmark? __________________________

How many years has the family lived in Denmark? ____________________________

From what source did you first hear of HIS? _________________________________

Date                                                Signature of Parent (s) or Guardian (s)    

_____________________________________________________________________

Hørsholm International School, Christianshusvej 16, 2970 Hørsholm, Denmark

Telephone 0045 45 57 26 16 Fax 0045 57 26 69

Email: his@ngg.dk