Bethany School

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Title

Child's Name

Full Name

(including initial)

Child's Surname (if different)

Child's Gender

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Relationship to child

Child's Date of Birth

Telephone

Proposed Year of Entry

Mobile Phone

Child's Current School

Email Address

Address

Child's interests
or other information

Postcode/Country

Day or Boarding?

Day Boarding

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of Bethany School?

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