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Primary School
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Reception Admissions Form
Reception Admissions Form
1. Student Details
On completion of this form please email to admin.aldersbrook@redbridge.gov.uk the following documentation: 1) 2 x proofs of residency from the last 3 months i.e Rent book/Tenancy agreement, Council Tax Bill, Mortgage Statement, Bank/Building Society Statement or Utility Bill. 2) Proof of child’s date of birth i.e Passport or Birth Certificate
Legal First Name
*
Legal Middle Names
Legal Last Name
*
Gender
*
Male
Female
Other
Date of Birth (DD/MM/YY)
*
Student Address Line 1
*
Student Address Line2
Student Address Line 3
Student City/Town
*
Post code
*
Language
*
Select the following
*
Native Language
Speaks Language
Understands Language
Is Spoken at Home
Language 2
Select the following
Native Language
Speaks Language
Understands Language
Is Spoken at Home
Fluent in English?
*
Yes
No
Religion
*
Please Select
Anglican/Church of England
Baptist
Buddhist
Bulgarian Orthodox
Christian
Christian (Ecumenical)
Congregational
Free Church
Greek Orthodox
Hindu
Jainism
Jehovah's Witness
Jewish
Latter-Day Saints
Lutheran
Methodist
Muslim
No Religion
Orthodox Catholic/Eastern Orthodox
Other Religion/Faith
Pentecostal
Protestant
Quaker
Rastafari
Refused Information
Roman Catholic
Romanian Orthodox
Russian Orthodox
Salvation Army
Serbian Orthodox
Seventh Day Adventist
Shinto
Sikh
Ukrainian Orthodox
United Reform Church
Ethnicity
*
Please Select
White: British
White: Irish
White: Traveller of Irish Heritage
White: Other
White: Gypsy/Roma
Asian or Asian British: Indian
Asian or Asian British: Pakistani
Asian or Asian British: Bangladeshi
Asian or Asian British: Other
Black or Black British: Caribbean
Black or Black British: African
Black or Black British: Other
Chinese
Mixed: White and Black Caribbean
Mixed: White and Black African
Mixed: White Asian
Mixed Other
Any other ethnic group
Prefer not to say
Mode of Transport
*
Please Select
Walk
Cycle
Car/Van
Car Share
Bus
Train
Taxi
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2. Family Information
parent/guardian 1 details
Parent/Guardian 1 Title
*
Please Select
Mr
Mrs
Miss
Ms
Dr
Parent/Guardian 1 First Name
*
Parent/Guardian 1 Last Name
*
Parent/Guardian 1 Relationship
*
Parent/Guardian 1 Primary Guardian? (Y/N)
*
Yes
No
Parent/Guardian 1 Legal Guardian? (Y/N)
*
Yes
No
Parent/Guardian 1 Authorised to Collect? (Y/N)
*
Yes
No
Parent/Guardian 1 Lives with Student? (Y/N)
*
Yes
No
Address: If address is different from child please enter here
Parent/Guardian 1 Mobile Number
*
Parent/Guardian 1 Home Telephone Number
Parent/Guardian 1 Work Telephone Number
Parent/Guardian 1 Email Address
*
parent/guardian 2 details
For legal reasons, all schools require two main contacts for pupils. In many cases this will be a legal parent/guardian. If this is NOT a legal parent or guardian, instead please include details of a designated adult. For example, a close relative or friend who can be contacted if the Primary Carer cannot be contacted.
Parent/Guardian 2 Title
*
Please Select
Mr
Mrs
Miss
Ms
Dr
Parent/Guardian 2 First Name
*
Parent/Guardian 2 Last Name
*
Parent/Guardian 2 Relationship
*
Parent/Guardian 2 Primary Guardian? (Y/N)
*
Yes
No
Parent/Guardian 2 Legal Guardian? (Y/N)
*
Yes
No
Parent/Guardian 2 Authorised to Collect? (Y/N)
*
Yes
No
Parent/Guardian 2 Lives with Student? (Y/N)
*
Yes
No
Address: if different from child please enter address here
Parent/Guardian 2 Mobile Number
*
Parent/Guardian 2 Home Telephone Number
Parent/Guardian 2 Work Telephone Number
Parent/Guardian 2 Email Address
*
siblings
Details of Siblings at this School
Sibling 1
Sibling 2
Sibling 3
Name
D.O.B
Siblings in other schools
Sibling 1
Sibling 2
Sibling 3
Name
D.O.B
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3. emergency information
Please fill in details below of emergency contacts if we have difficulty contacting a primary guardian, we will contact the people provided below. Please place them in the order to be contacted in an emergency, giving details of their relationship to your child. E.g. Aunt/Uncle, Grandparent, Family Friend, Child Minder etc.
*
Emergency Contact 1.
Emergency Contact 2.
Name
Address
Postcode
Contact Number
Can Collect (Y/N)
Relationship to Child
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4. medical/health/send details
Details of Doctor
*
Doctors Name
Address
Contact Number
Does your child have any medical condition?
*
None
Asthma
Eczema
Allergy eg. Hayfever, medicine
Speech/Hearing
Eyesight
Other
Medication required by child?
Medication required by school?
If you have indicated any medical needs, please give further details here (please indicate if the condition is serious as it may require a care plan)
Please indicate any learning disabilities, including speech difficulties (plus details of any speech therapy) or any other problems which may affect your child’s learning.
Do we have permission to contact your doctor?
*
Yes
No
Do we have permission to administer first aid where necessary?
*
Yes
No
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5. dietary requirements
Please select the diet which best reflects your child’s needs:
*
Please Select
No requirements
Non-Halal
Halal
Vegetarian
Vegan
Does your child have any food allergies? If there are any food allergies, you are required to fill in a special diet form and the catering company requires a medical note from the doctors which allows them to cater to the child’s needs.
*
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6. additional funding
The Government is giving money to schools to help children from lower income families do their very best. This funding is called ‘Early Years Pupil Premium’. For every child registered Aldersbrook Primary School will receive a maximum of £300 this year (April 2020). With this money we could provide: Opportunities for funded learning support such as tuition and after school activities Free music tuition Reduced costs for educational visits and residential trips Subsidised after school clubs Subsidised Breakfast Club A free book from the school Book Fair Resources to support areas such as: Literacy, Mathematics and Knowledge and Understanding of the world More interventions to accelerate your child’s academic progress Interventions to develop self-esteem, self-confidence and social emotional skills. Who Qualifies for Free School Meals and Pupil Premium funding? Free School Meals and Pupil Premium funding can only be awarded if you or your partner are claiming: Income Support Income-based Jobseeker’s Allowance Income-related Employment and Support Allowance Support under part VI of the Immigration and Asylum Act 1999 The guaranteed element of State Pension Credit Child Tax Credit based on an annual gross income of no more than £16,190 Working Tax Credit run-on Universal Credit Or your child has been: Looked after by the Local Authority for at least one day, or is currently in care Has been adopted from care Has left care through special guardianship Has been subject to child arrangement order setting with whom the child is to live (formerly known as residence orders) How to apply Check if you qualify by looking at the list above Complete the form online on www.redbridge.gov.uk/schools/free-school-meals/ Additional Information If you feel you meet the criteria, please complete the online form to initiate possible Pupil Premium funding for your child. Applications are confidential and it will not affect any other benefits you are claiming. If you have any further questions or require support in applying, please contact Mrs Kari, Assistant Head Teacher for KS2 and Pupil Premium.
If you would like assistance with your application or to discuss this with a member of staff please tick here
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7. consent
Please tick to consent:
*
Visits: We will contact you prior to a visit and the children will be supervised at all times. • I give permission for my child to be taken on school visits in the local area (Wanstead flats, Wanstead park, Wanstead high street, School allotment, Local library, Venue for school productions – the local church and Wanstead High School etc.)
Please tick to consent:
*
Digital and Media Permission: I give permission for my child to be involved in activities in school using digital media, videos, photographs and podcast (for examples: school website/displays/documents/video conferencing/local and national newspaper) • I understand that I may withdraw this consent at any time by writing to the office
Opt-out: I do not wish for my child to be included in images, videos or other digital media created in school and displayed as wider content. I give permission for my child to be involved but not for their image to be used.
Please tick to consent:
*
Attendance: In the event of my child’s absence, I will inform the school office before 9:30am • If for any reason my child is late for school but requires a school lunch, I agree to inform the school by 9:30am
Please tick to consent:
*
Behaviour: I agree to support the policies of the school and to encourage my child to follow the school golden rules and to behave with consideration to other people
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8. declaration
Please Confirm
*
I have read and understood the content of this form. The information given on this form is correct.
Please Confirm
*
I understand that I MUST inform the school should the details given change.
Please confirm
*
I have read and understood the Home-School Agreement
Please confirm
*
I have read and understood the Online Safety Agreement
Confirmation - Primary Guardian 1
*
Digital Signature
Relationship to child
Confirmation - Primary Guardian 2
Digital Signature
Relationship to child
Data Protection Act 1998
The School is collecting this data in order to meet its statutory responsibilities for the provision of education to children in accordance with the requirements of the Education Act 1996 and The School Standards and Framework Act 1998. Some of this data will be shared with the Local Authority and may be shared with other agencies that are involved in the health and welfare of school children. The School also adheres to GDPR guidelines with reference to storage of data. No data will be shared with third parties at any times.
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9. proof of identity and address
We are required to undertake satisfactory checks to ensure the Identity and Address of Children enrolled at Aldersbrook Primary School. Please supply the following to complete registration.
Please enter a valid email address to receive confirmation of submitted form:
*
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Reception Admissions Form