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If your child is starting school in September 2022 please do not complete this form until after national offer day (19 April 2022) when you have formally been offered and accepted a place.

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* 1. What is your child's name(first name, middle name (s) & surname please) and date of birth?

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* 2. Parents can register their child for Pupil Premium Funding if they are in receipt of any of the following benefits:

·         Universal Credit (provided you have an annual net earned income of no more than £7,400)
·         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 Pension Credit
·         Child Tax Credit (provided you’re not also entitled to Working Tax Credit and have an annual gross income of no more than £16,190)
·         Working Tax Credit run-on (paid for four weeks after you stop qualifying for Working Tax Credit)

For details on what Pupil Premium Funding can provide for the school and your child, please visit the following website:

https://www.gov.uk/government/publications/pupil-premium/pupil-premium

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* 3. Does your child attend a preschool setting?

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* 4. What are the names of the settings your child has attended? (If you answered No to Question 3, please move straight to Question 7)

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* 5. How many hours do they attend a week?

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* 6. How well did your child settle at their current setting?

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* 7. Does your child have any current or historical Additional Needs?

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* 8. Does your child have any of the following additional needs? 

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* 9. Does your child have any medical needs? 

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* 10. If your child has any medical needs, the school will ask for evidence of this. Please indicate if you are able to provide evidence? If your answer is "My child does not have any medical needs", move to Question 12

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* 11. If your child has a medical need or any allergies please explain what they are and whether they WILL REQUIRE MEDICATION to be administered at school. 

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* 12. Please provide your child's NHS number (if known) and details of the General Practitioner that they are registered with.

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* 13. Please provide details of the primary carer (this will be our first point of contact for your child):

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* 14. Please provide details of the secondary carer (this will be our next point of contact for your child). If you both live at the same address, please enter "As Above"

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* 15. Do both parents have equal parental rights? (This information will be kept confidential)

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* 16. If BOTH parents do NOT have equal parental rights, the school cannot adhere to this unless proof from a court order is provided. (This information will be kept confidential)

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* 17. Is your child currently working with any other professionals at the moment?

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* 18. Do you need to meet with our SENCo to discuss any Special Educational Needs?

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* 19. Do you need to meet with our Designated Safeguarding Leader to discuss any current/historic child protection or safeguarding information?

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* 20. Does your child have any dietary needs?

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* 21. Does your child hear another language at home? (Please name the language(s) they hear)

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* 22. What is your child's ethnicity?

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* 23. What is your child's religion?

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* 24. SAFEGUARDING INFORMATION: Your child will ONLY be allowed to be collected by a named person on the authorised pick up list. This may mean that the school will ask them to provide identification if they are not known to us. It is your parental responsibility to ensure the authorised list is up to date. This is for your child's safety.

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* 25. Please provide us with the contact information for two individuals you would like us to contact in the event of an emergency. These are two people other than the child's parents

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* 26. Please provide a list of anyone you authorise to collect your child from school and their contact number. (First & Surname please)

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* 27. The school provide a lot of information on social media platforms (Facebook & Instagram) and the school website. Please indicate if you give permission for your child to be on social media.

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* 28. Whilst we request that all parents/carers do not post any pictures/videos on social media when attending school events, the school cannot be held accountable if this request is not adhered to.

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* 29. We are looking forward to your child joining us in September 2021. If you feel there is any other information that you would like to share please do so.

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* 30. I confirm I have read, understood and agree to follow the school policies: 

  • Home/School Agreement
  • Attendance Policy
  • Online Safety & Acceptable Use Policy and Agreement (p.g.35)  
  • School Uniform Policy 
  • Personal & Intimate Care Policy
  • Sex and Relationships Policy

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