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Guardianship Application Form


Student's Details

Parent 1 Details
Parent 2 Details
Guardianship Details
Eg. 2 Year A Level, GCSE, etc.
Previous UK Education
Other contacts - if you know any person in the UK, please fill out this part
Other contacts 2
Further information

Please write below anything additional you would like us to know, anything confidential that you prefer we do not pass on to your son or daughter’s Home Stay Family, also anything that you expressly forbid.

Signature

www.HEGS.org.uk Tel. 0044(0)1384 413 401 – info@HEGS.org.uk

Heart of England Guardianship Services Ltd is a company registered in England and Wales, no 07706633.
Our registered address is 29 Beauty Bank, Cradley Heath, B64 7HZ, UK.

Confidential Medical Form

Please note that essential information will be passed to home stay families.

Please answer ALL questions.

Do you have, or have you ever had any of the following?


















Signature
Signature

www.HEGS.org.uk Tel. 0044(0)1384 413 401 – info@HEGS.org.uk

Heart of England Guardianship Services Ltd is a company registered in England and Wales, no 07706633.
Our registered address is 29 Beauty Bank, Cradley Heath, B64 7HZ, UK.

General Consent for Medical Treatment

I have provided general medical information on the HEGS Medical Form and informed HEGS staff of all relevant medical information.

I authorise HEGS to consent on my behalf to my son/daughter receiving emergency medical treatment, including blood transfusions within the United Kingdom, general anaesthetic and operations under the National Health Service or at a private hospital certified by an appropriately qualified person necessary for thechild's welfare, and if I cannot be contacted in time.

HEGS will endeavour to contact parents at the earliest opportunity should such emergency medical treatment be deemed necessary.

Signature

www.HEGS.org.uk Tel. 0044(0)1384 413 401 – info@HEGS.org.uk

Heart of England Guardianship Services Ltd is a company registered in England and Wales, no 07706633.
Our registered address is 29 Beauty Bank, Cradley Heath, B64 7HZ, UK.