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  1. Student's Name *
    Please enter the student's name
  2. Parent's Name *
    Please enter the parent's name
  3. Student’s date of birth *
    Please enter the student's date of birth
  4. Current School *
    Please enter your childs current school
  5. Current Year Group *
    Invalid Input
  6. Proposed A-level subject 1 *
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  7. Proposed A-level subject 2 *
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  8. Proposed A-level subject 3 *
    Invalid Input
  9. Proposed A-level subject 4 (optional)
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  10. Proposed A-level subject 5 (optional)
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  11. Please enter your postal address *
    Please enter your full address
  12. Parent's Email *
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  13. Student's Email *
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  14. Contact Number (must be a parent) *
    Please enter your telephone number
  15. We will keep your information for the sole purposes of contacting you about Westholme, as a legitimate interest. In line with GDPR law, we will not pass on your data to any other third parties