Secondary School Exchange scholarship 1. Application form Completed forms should be returned to education@esu.org SSE – Education Department The English-Speaking Union Dartmouth House 37 Charles Street London W1J 5ED I am applying for the 3 term/2 term SSE scholarship (please delete as applicable) Personal Details Title:
First Name:
Surname:
Date of birth: Country of Birth
Gender: Nationality (as on your passport):
School: Home address:
Home telephone number: Mobile: Email (required): Name of parent/guardian: Living with: both parents / one parent / guardian (please delete as applicable) Email of parent (s)/guardian(required):
Daytime telephone number of parent/guardian: School Address:
School telephone number: