Name of School

Address

Boarding School Allowances

School term from

to

APPENDIX IV

I certify that

(Name of pupil)

is a full-time/weekly boarder

at this school and that his/her school fees have been fully paid as indicated

below.

School fees (see Note 1 below)

Assistance (if any) towards the above school fees granted specifically for this pupil and paid to the school by an education authority or any other public/

private body. (see Note 2 below)

Please affix seal or rubber stamp of school

Amount

SIGNATURE

(Principal/Bursar)

NAME IN

BLOCK LETTERS

DATE

1

NOTES:

1.

2⭑

The basic boarding and tuition fee as advertised in the school's prospectus.

A scholarship won by a child on a competitive basis will not be considered as assistance.

0.1.4.3

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