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Brookham School

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Title*		Child's Name*
Full Name*		Child's Surname (if different)
Relationship to Student		Child’s Date of Birth*
Telephone*
Mobile phone		Proposed Year of Entry*
E-mail Address*		Child's Current School
Address*		Child's Interests or other Information


Town*
County
Postcode/Country*

Are you interested in a Day OR Boarding place? *	Day Boarding
How did you hear of Highfield School?*
message or question