In Year Admissions 2024/2025

Student details (Please use block Capitals)

Legal Forename:*

Legal Surname:*

Preferred Forename:

Preferred Surname:

Middle Name(s):

Date of Birth:*

Permanent Address:*

Address line 1 Address line 2 Town/City County Postcode

Gender* MaleFemale

School Year Group Applying For:*

Is the child Looked After, or were they previously looked after?YesNo

Does the child have an Educational Health Care Plan (please provide paperwork)YesNo

If the child has an Educational Health Care Plan (please provide paperwork)

Was the child on the SEND register at the previous school (please provide written diagnosis)YesNo

If the child was on the SEND register at the previous school (please provide written diagnosis)

Do you have parental responsibility for the child?YesNo

Parent/Carer Details:

Forename:

Surname:

Permanent Address:

Address line 1 Address line 2 Town/City County Postcode

Email Address:

Contact Number:

Current School:

Name and address of current/last school and dates attended:

Names of other previous school/s:

Do you consent for us to contact your child’s current/last school for further information?YesNo

Reason(s) for wishing to change schools:

Has the child ever been permanently excluded or suspended from school?YesNo

If yes to being excluded or suspended, please provide details

If KS4 – Please List GCSE options chosen:

Application Criteria

Please select which criteria you wish your application for the child to be considered. You may select more than one.

Criterion 1 - Looked After Children *Criterion 2 - Medical or Social *Criterion 3 - Sibling - (If Selected, Please provide name & form group of sibling below)Criterion 4 - Children of Staff - (If Selected, Please provide Staff Member Name Below)Criterion 5 - Distance *

Criteria 1 - Looked After Children OptionsLooked-after childAdopted from careResidence order from careSpecial Guardianship Order from care

Criteria 1 - If selected above as a Looked After Child - Please include a letter from Social Services, other relevant statutory bodies or an appropriate professional.

Criterion 2 - If selected Medical Or Social above - Please provide supporting Documentation

Criterion 3 - Sibling – If Selected above, Please provide name & form group of sibling:

Criterion 4 - Children of Staff – If Selected Above, Please Provide Staff Member Name:

Criterion 5 (Distance) - You must provide all of these documents showing the names of all adults living at the property:

Most recent council tax statement, current utility bill, rental agreement/mortgage statement.

Criterion 5 - Distance - If selected Above, please provide Documents.

Parental Declaration:

If you deliberately give false information, the offer of a school space may be withdrawn. All of the information I have given on this form is correct and up-to-date. I understand that you will inform my child’s current school of this application and will share the information in this application with the local authority. I understand that my child must be able to take up the allocated school space immediately and that the place may be withdrawn if not accepted within 10 school days.

For further information on what we do with your data please look at our Policy and Privacy notice section on our website.

Signed..

I confirm that the information provided is true and correct.I confirm that I have parental responsibility for this child and/or the agreement of all parents with parental responsibilityI enclose all of the supporting documentation

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