SURVAL MONTREUX - ACADEMIC YEAR APPLICATION FORM

Application form to join Surval Montreux. Please complete all sections.

Student Details

Upload your daughter's photo

Passport Upload*

Last Name*

First Name*

First Name to be used in School

Country of Nationality*

Date of Birth*

Day/Month/Year

Place of Birth*

Passport Expiry Date

Day/Month/Year

Passport Number

First Language *

Other Languages spoken

If the student has any siblings, please provide their names and dates of birth

Which Programme are you applying for?*

Academic Year of Entry*

Term of Entry (Surval)*

Duration of Stay*

Parent / Legal Guardian Details - Main Contact

Relationship to Applicant *

Last Name*

First Name*

Email*

Street Address *

City*

State/Region

Postal / Zip Code*

Home Phone

Mobile Phone *

Country *

Profession *

Parent / Legal Guardian Details - Second Contact

Relationship to Child*

Last Name*

First Name*

Email*

Street Address*

Postal Code*

City

Country*

Home Phone

Mobile Number

Profession *

Where did you hear about us? *

Person responsible for fees*

Agent Information

Have you used an Agent for this Application?*

Current School Information

Current School Name*

Name of current Principal

Current School Email

Years of Attendance *

Please upload School reports of the two previous years *

Teacher Reference

We will contact the teachers below for a confidential reference.

Name of Math Teacher*

Email*

Name of English Teacher*

Email*

Name of Counselor *

Counselor Email *

School History

Please specify names of all schools, years of attendance since Grade 6 and reason for leaving*

Additional Notes

By submitting this from, we confirm our agreement with the general and financial conditions set out in our fees and financial conditions. By signing below, we as parents (or legal guardians) agree to abide by these conditions and to respect the School’s rules and regulations as set out in the Code of Conduct.

We undertake to honour this contractual agreement even when our daughter reaches the legal age of adulthood and until she leaves Surval Montreux. We understand that discovery of false or incomplete information may jeopardize our daughter’s right to remain at the School.

We authorise Surval Montreux to undertake the necessary action to obtain a student residence permit for our daughter who guarantees to leave Switzerland at the end of her studies.

Date of registration*

Day/Month/Year

Learning Support or Social Emotional Needs Documents (If Applicable)

Signature Parent*