Name
email
Sex
Date of birth
Nationality
Name and address of parent or guardian
Home telephone number
Contact number during student's stay
Name and address of person responsible for fees (if different from above)
Date of arrival Date of departure    
By whom was the recommendation made?
 
CONDITIONS OF ACCEPTANCE
1 Fees must be paid in full at least one month before the start of the visit. The college will not guarantee to hold places for students who have not paid in advance.
2 Fees are not refundable in any circumstances. Parents are advised to arrange comprehensive insurance including cover for the payment of fees in case a student is away through illness or accident.
3 The college reserves the right to dismiss any student whose standard of conduct is unsatisfactory, at the discretion of the Headmaster, whose decision shall be final.
4 You have read and agreed to the terms and conditions set out above and request Hurtwood House to reserve a place for the student for the period mentioned above.
 
If it is desired to make a firm reservation, please submit this form and remit the registration deposit of £250. This is deductible from the fees when they are paid in full. Cheques should be made payable to Hurtwood House, or credit transfer made direct to National Westminster Bank plc, 14 High Street, Dorking, Surrey. Account Hurtwood House No 03725219. Sort code 60-07-02. It is essential to quote the student's name when making payment.
Hurtwood House, Holmbury St. Mary, Dorking, Surrey RH5 6NU Tel: + 44 1483 277416
Fax: + 44 1483 267586 E-mail: info@hurtwood.net
 
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