SurveyMonkey Powered Online Survey

1. New Pupil Data Collection

This survey collects essential information about your your child and will ensure that we are fully prepared to fulfil our duty of care when your child attends school. It will also enable us to make appropriate steps to provide additional educational support where necessary.

We recommend that all parents read our Data Protection Privacy Notice which explains why we require additional pupil information and how we will use it.

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* 1. Consent

I am happy for the school to collect and use personal data for the above purposes.

I do not wish the school to collect and use personal data below for any of the above purposes.

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* 2. The first name of the parent / carer completing this form

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* 3. The surname of the parent / carer completing this form

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* 4. Relationship of the adult completing the form to the child being recorded

Parent

Carer

Other (please specify)

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* 5. Your Child's first name

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* 6. Your Child's surname

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* 7. Date of Birth

Use the calendar button to select your child's date of birth

Date

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* 8. Year 3 class

3LE - Miss Evans

3JB - Miss Bowyer

3LO - Miss Orchard

3OC - Miss Crowley

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* 9. Nationality

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* 10. Religion

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* 11. Ethnicity

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* 12. Country of Birth

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* 13. Your child's First / Main / Spoken Language

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* 14. Home Language (language spoken most frequently at home)

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* 15. Fluency in English

Early Learning

Developing

Competent

Fluent

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* 16. Mode of travel to school

Walk

Car

Other (please specify)

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* 17. Sibling(s) Names (if applicable)

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* 18. Sibling(s) schools (if applicable)

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* 19. Previous School Name

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* 20. Is a Court Order in force for your child?

Yes

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* 21. If a Court Order is in force for your child, please provide details below. We will request that you send a copy of the Court Order to the school for our records.

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* 22. Is your child currently under a Child Protection Order?

Yes

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* 23. If a Child Protection Order is in force for your child, please provide details below. We will request that you send a copy of the Child Protection Order to the school for our records.

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* 24. Is your child currently registered to receive free school meals?

Yes

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* 25. Is your child recorded on their current school's Special Needs register?

Yes

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* 26. Does your child have a formal diagnosis for any additional need, for example, ASD, ADHD, Dyslexia? If so what is their diagnosis?

Yes

If you answered Yes, please provide a brief explanation below.

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* 27. Is your child currently in receipt of an EHCP (Educational and Health Care Plan) include option?

Yes

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* 28. Has your child ever been in receipt of an EHCP? include option for yes

Yes

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* 29. Is your child currently in receipt of a PEP (Personal Educational Plan)?

Yes

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* 30. Is your child currently in care?

Yes

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* 31. Are either of the child's parents employed in the British Armed Forces?

Yes

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* 32. Are either parent or carer identified as Key Workers according to the DfE categorisation in relation to the Coronavirus pandemic?

Yes

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* 33. Does your child receive travel assistance from the Local Authority?

Yes

If you have answered 'Yes' to any of the above questions, please ensure you discuss this with the school office, SENCO or Headteacher and provide copies of key documents.