APPLICATION FORMSCHOOL YEAR

Last name: First name(s):

Date of birth: (d / m / y) Place of birth:

Gender: male female Religion:

Nationality: Native language:

Father’s last & first name: Father’s profession:

Mother’s last & first name: Mother’s profession:

Address:

Postcode: Town /City: Country:

Email Father: Email Mother:

Telephone landline: Fax:

Mobile phone Father: Mobile phone Mother:

Possible second address:

Street:

Postcode: Town /City: Country:

Email:

Billing address (if different from above)

by email to:

The student mentioned above is hereby enrolled at Institut auf dem Rosenberg (school education / boarding school). By signing this application form, the parents confirm to have received the Institut’s General Terms and Conditions, the List of Fees and Prices, and the House Rules for the boarding school, all in their current versions, and to accept all of them as legally binding. Swiss Law shall be applicable to this contractual relationship. Place of jurisdiction is St. Gallen (Switzerland).

Signed by Father: Signed by Mother:

APPLICATION FORMSCHOOL YEAR

Intended career aim:

Schools attended (last 3 years)Name of school: from – till: classes attended:

I hereby authorize Institut auf dem Rosenberg to contact my son’s / daughter’s previous schools to request school transcripts and / or references.

Which foreign language(s) has applicant previously studied?German French English Latin Italian Spanish other

From which class / year:

How did you find our school?Friends Internet Agency: other:

When you have completed and signed this application form, please enclose all of the following:• report cards from the last three school years • photocopy of applicant’s passport • handwritten motivation letter • a photo in passport format

The undersigned declare that to the best of their knowledge, they have provided, in detail, all information regarding the applicant’s possible mental or physical illness and that he / she never had contact with narcotic drugs.

Signed by Place and date: applicant (student):

Signed by father: Signed by mother:

Entry date: Approx. length of stay:

1. The Tuition and boarding/accommodation fees fall due at the beginning of the school year. The fees may be paid in full at the start of the school year, or separately for each term.

2. Upon a student’s registration, a deposit in the amount of CHF 25’000.00 falls due, in accordance with point 7 of the General Terms and Conditions. The deposit shall be credited without interest to the student’s final statement of accounts, provided the withdrawal is in accordance with point 6 of the General Terms and Conditions; if it is not, the deposit shall be forfeit in accordance with point 9 of the General Terms and Conditions.

3. The tuition and boarding fees include: the full cost of compulsory schooling as described for the respective level and sections, three meals daily, accommodation in a standard double room with separate shower/WC as well as the use of Institut auf dem Rosenberg’s sports and games facilities (tennis courts included).

4. The tuition and boarding fees do not include: special remedial tuition, as in the case of change of course and/or as necessitated by student’s non-native language level; deviation from the standard languages; compulsory health and accident insurance; laundry and drycleaning; any extra educational psychological assessment or care; music tuition; school books and materials; specialised sports activities (such as skiing, snowboarding, horseback riding, golf etc.); travel money; special events, outings and excursions; personal shopping; state registration fees and taxes; visa fees; repairs to damaged school property; dentist’s fees; hairdresser’s fees; telephone charges; examination fees; College Counselling; night disturbance fines; single rooms; rooms with shower/WC en suite; rooms with shower/WC en suite shared; storage fees; extra service charges due to arrival or departure outside of regular times; delayed arrival; visa application; transport of luggage items; purchase of travel tickets etc. All of these services will be invoiced in accordance with Institut auf dem Rosenberg’s service tariffs.

5. Students are granted a place in order of application, and on receipt of the deposit fee. The final account will be issued approximately three months after the student’s departure.

6. There is a charge of CHF 500.00 for each exam passed (Swiss Baccalaureate, German Abitur, AS & A2 Level, Italian Matura) and for each language diploma or certificate. All examination fees are to be paid in advance. The tuition and boarding fees for the graduating student’s last term is charged and invoiced in advance in December of the preceding year. In addition a specified sum will be levied to cover any further extra costs. The term in which school leaving examinations take place, is to be considered as a full term, no matter when the final examinations are held.

7. No financial credit will be allowed for occasional absence during term time.

8. Laundry (washing, ironing) and drycleaning of students’ clothes can be done in St.Gallen, if requested. These services will be invoiced separately.

9. For understandable reasons the school cannot take responsibility for any financial transactions made by the parents. All bank charges, commission fees, exchange losses and the like, must be at the cost of the parents. The school is entitled, in case of incomple te sett-lement of accounts, to withhold the student’s final report card or graduation document.

10. Students with above-average school results and exemplary conduct in both school and boarding school may apply for a partial scholarship.

Institut auf dem Rosenberg AG

Bank details: St.Galler Kantonalbank, St.Gallen, IBAN CH60 0078 1011 0024 3490 5; Swift KBSGCH22Credit Suisse, Zurich, IBAN CH29 0483 5032 3184 3100 0; Swift CRESCHZZ80A

Fees and prices in detail

per term CHF 28’000.00per school year (3 terms) CHF 84’000.00All prices quoted in Swiss Francs (CHF).

INSTITUT AUF DEM ROSENBERG AG ST.GALLEN / SWITZERLAND

STATE OF HEALTH

Last name: First name(s):

Date of birth: (d / m / y) Place of birth: Entry date:

Height: Weight: Blood type:

Fitness for sports: very good good moderate

swimmer non-swimmer

Allergies: none yes

If yes, please name:

Medication the child has to take regularlyMedication: Dose: Reason / diagnosis:

Mental health issues (also in family):

Are there any mental or physical particularities that should be considered? Any important fact concerning applicant’s health?

The parents / the child’s legal guardian authorise /s Institut auf dem Rosenberg to take the measures required to safeguard the child’s health.

Signed by Place and date: applicant (student):

Signed by father: Signed by mother: