Schools are required by law to keep on record details of children admitted. We should therefore be grateful if you could complete all of the questions within this form when your child is admitted. A copy of your child’s long version birth certificate/passport and proof of address should be uploaded to this form when indicated for the School to place on file at the time of your child’s admission to primary education.
Pupil Address Details
Main (home address)
Alternative address (non term time)
If the child’s residence at the present address (whether living with parents or any other person) is not permanent, please state the reason and probable duration of the stay, and give the name and address of the person with whom the child normally resides:
It would be very helpful to have available the details of any siblings who are currently attending, have attended this school, or are likely to join this school at a later date.
Please include forename, surname, date of birth and current school for each sibling in the box below
Parent / Carer Details
Parent / Carer 1
Address (if different to pupil)
Parent / Carer 2
Address (if different to pupil)
OTHERS WITH PARENTAL RESPONSIBILITY AS DEFINED BY CHILDREN ACT 1989
Parental responsibility may be shared between a number of people beyond the child’s natural parents, for example those with a Parental Responsibility Order. Married parents have equal parental responsibility; on separation or divorce both parents continue to have responsibility. In such circumstances the school will forward copies of school reports, etc. to the separated parent if requested.
From time to time it may be necessary to contact someone during the school day, e.g. in the case of a child’s sickness. Please list below (in order of preference) all details of any additional person(s) from those above who we can contact on such an occasion.
Alternative contact 1
Alternative contact 2
Pupil Medical Information
Knowledge about your children’s health is vital if we are to help them to achieve their potential educationally. Would you please supply the following medical information about your child. This information will only be shared with relevant professionals within education and health who need to know in order to support your child in school. If you wish to discuss your child’s health confidentially, please contact the School Nurse.
Disabilities - a child is considered to have a disability if their parent indicates substantial and/or long term difficulties with one or more of the areas listed below. Please exclude difficulties that you would expect for a child of their age.
Pupil Ethnic/Cultural Information
The Department for Education (DfE) has asked for the collection of the following information for all pupils.
FIRST LANGUAGE - the language to which your child was first exposed in their early childhood and which they continue to use or be exposed to at home or in your community.
Additional Pupil Information
Service Children in Education Indicator – are one or both parents Service personnel, serving in regular military units of any of the HM Forces, or in the Armed Forces of another nation and stationed in England and exercising parental care and responsibility?
Previous School History
DATA PROTECTION STATEMENT: The purpose of this form is to collect data for further processing within the school/Local Authority/Health Authority systems. The data will be processed in accordance with the purposes notified by the school/Local Authority/Health Authority to the Data Protection Commissioner's office and are subject to the Data Protection Act and the General Data Protection Regulation (EU) 2016/679. The information given will be entered onto a computer and will form part of the School’s database. Please refer to our Pupil and Parent Privacy Notice on our website for further information on how we collect and use pupil information.
Entering your name in the signature box below on this form implies your consent for the school/Local Authority/Health Authority to process the data.
DECLARATION OF PERSON WITH LEGAL RESPONSIBILITY:
I declare the above information to be correct to the best of my knowledge at the time of completion.
I agree to notify the school of any change in my child’s circumstances.