Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. In Year Admission - Pupil Details Form 2021 If you have been formally offered and accepted a place at Joydens Wood Infant School, please complete this form as soon as possible. This is NOT for children joining EYFS in September 2021. OK Question Title * 1. What is your child's name (first name, middle name (s) & surname please) and date of birth? First Name Middle Name(s) Surname Date of Birth OK Question Title * 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 I am eligible for Pupil Premium Funding I am not eligible for Pupil Premium Funding I am unsure and would like the school to contact me OK Question Title * 3. What are the names of the settings your child has attended? Name of Setting 1 Dates (to and from) Name of Setting 2 Dates (to and from) Name of Setting 3 Dates (to and from) OK Question Title * 4. How well did your child settle at their current setting? Very well Needed some support initially e.g. first couple of sessions Needed ongoing support for more than a month Required a high level of support e.g. a bespoke plan was needed Unsure OK Question Title * 5. Does your child have any current or historical additional needs? My child has additional needs (this can include anything that is still being explored by professionals) My child had historical needs but these are no longer present My child has no additional needs Unsure - I would like to speak to the SENCo OK Question Title * 6. Does your child have any of the following additional needs? Speech and Language difficulties (please select even if this is historic) Communication and Interaction difficulties (please select even if this is historic) Physical difficulties (please select even if this is historic) Toileting needs (please select even if this is historic) - child should be toilet trained on entry, unless they have a physical need preventing them from being able to do this. Challenging behaviour at home Challenging behaviour at their setting Sensory needs Unsure No Other (please specify)/ My child has a diagnosis (please explain) OK Question Title * 7. Does your child have any medical needs? Yes No OK Question Title * 8. 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 13 I can provide medical evidence I cannot provide medical evidence My child does not have any medical needs OK Question Title * 9. 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. OK Question Title * 10. Does your child have a sibling at Joydens Wood Junior School (or is joining the Juniors at the same time)? If so, please can you provide their name and class Name of Child * Class OK Question Title * 11. Please provide your child's NHS number (if known) and details of the General Practitioner that they are registered with. NHS Number for Child Doctor's Name Surgery/Practice Phone Number OK Question Title * 12. Please provide details of the primary carer (this will be our first point of contact for your child): Name Address Address 2 City/Town County ZIP/Postal Code Email Address Phone Number OK Question Title * 13. 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" Name Address Address 2 City/Town County ZIP/Postal Code Email Address Phone Number OK Question Title * 14. Do both parents have equal parental rights? (This information will be kept confidential) Yes No OK Question Title * 15. 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) I can provide a court order for the school I cannot provide a court order for the school (please explain why below) Both parents have equal parental rights Other (please specify) OK Question Title * 16. Is your child currently working with any other professionals at the moment? Social Services Early Help SEN specialists e.g speech and language therapist, OT, physio, EP My child's currently being supported by the setting's SENCO My child is not needing support from any other professionals Other (please specify) OK Question Title * 17. Do you need to meet with our SENCo to discuss any Special Educational Needs? Yes No OK Question Title * 18. Do you need to meet with our Designated Safeguarding Leader to discuss any current/historic child protection or safeguarding information? Yes No OK Question Title * 19. Does your child have any dietary needs? Allergies (please describe below) Vegetarian Vegan Pescatarian My child has complex needs and I would like to meet the Catering Manager No dietary needs Other (please specify) OK Question Title * 20. Does your child hear another language at home? (Please name the language(s) they hear) OK Question Title * 21. What is your child's ethnicity? OK Question Title * 22. What is your child's religion? OK Question Title * 23. 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. I understand the importance of providing the school with an updated authorised pick up list. I don't understand why this information is necessary, I would like to speak to the school's Designated Safeguarding Leader Other (please specify) OK Question Title * 24. 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 Contact 1 Name Contact 1 Relationship to Child Contact 1 Number Contact 2 Name Contact 2 Relationship to Child Contact 2 Number OK Question Title * 25. Please provide a list of anyone you authorise to collect your child from school and their contact number. (First & Surname please) Contact Name 1 Contact Number 1 Contact Name 2 Contact Number 2 Contact Name 3 Contact Number 3 Contact Name 4 Contact Number 4 OK Question Title * 26. 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. I do not give permission I do give permission OK Question Title * 27. 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. I understand that the school has no authority to enforce this. I do not understand and would like to speak to the Designated Safeguarding Leader. OK Question Title * 28. We are looking forward to your child joining us. If you feel there is any other information that you would like to share please do so. OK Question Title * 29. 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 (pg.35) School Uniform Policy Personal & Intimate Care Policy Sex and Relationships Policy By selecting this box, I confirm I agree to adhere to the school's policies. I would like further information about the policies before I can agree. (Please note your child will not be enrolled unless you agree to our school's policies). OK THANK YOU FOR COMPLETING THIS IMPORTANT INFORMATION.