In-year common application form (ICAF)

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1 In-year common application form (ICAF) I Pupil ID Number: (office use only) Admissions Date Stamp (office use only) Parental Declaration Please use black ink and BLOCK CAPITALS and tick any boxes that apply. Please carefully read the guidance notes in the Finding a school place booklet available from before filling in this form. You must fill in section A and Section B should be filled in by the child s previous school in the UK. Once you have filled in all sections of the form you must sign the declaration, and return your application and the documents we ask for. If you post your application, please do so using the details at the end of this form, we advise doing this by registered post. I confirm that I am the person with parental responsibility for the child named in section A1. I have fully read and understood your admission criteria and want to apply for a place at each of the schools listed in section A5, and will list these schools in order of preference. This means that I no longer want to apply for any schools that I named on any previous forms and which I have not named on this form. The ranking of my preferred schools on this form is my current ranking, so please ignore any previous ranking order. I believe the facts I state in this application to be true and accurate. I understand that if I give false or deliberately misleading information on this form or supporting information, then this application will no longer be valid and may be a criminal offence. This could result in the withdrawal of the school place offer and/or prosecution. I am aware that if I intentionally provided false or misleading information in this application, there may be a financial loss to Havering Council due to the expense of funding a school place for my child. Section A (To be filled in by parent or carer) 1. Childs details First name: Last name: Date of birth: Day Month Year Sex: M F Year Group: Home address and postcode (A child s home address is defined as the child s normal place of residence, and excludes any business, relative s or child-minder s address. Where there is a formal residence order or child arrangements order a copy of the order will be required to identify which address is to be used). Postcode When did you move to this address? Day Month Year Previous home address: Postcode Name of child s current or previous school: Is the child still attending this school? Yes No Address and postcode of current or previous school: 2. Children with additional needs Does your child have a full statement of SEN or Educational Health Care Plan (EHCP)? Yes No Does your child have any other needs you feel we should know about? Yes No If Yes, please give details.

2 3. Children in Care / Previously in care If the child is or has been in the care of a local authority please say which: Social workers name: Phone number: Please also provide a letter from the social worker confirming the legal status of the child and name of the local authority the child is / was in the care of. The letter should also provide the reasons for the preferences for the schools listed. 4. Non - UK applicants Which country was the child born in? Date of entry to the UK: Day Month Year Is the child in the country now? Yes No Child s first language: Has your child ever studied english? Yes No If yes for how long: 5. School preferences Note 1. Please write the name and borough of up to four different schools you want to apply for. You must list the schools in the order you prefer them. You must list all schools or academies (not private schools) you are applying for. Note 2. Please include the name, date of birth and sex of any relevant sibling (brother or sister) who is already at a school you are applying for. Sibling includes a full, half, step, adopted or long-term fostered brother or sister living at the same address and currently at the school. Note 3. If you want to give reasons for your preference for any school, please use the section provided. These might include religious, philosophical or any other reasons. If you think there are exceptional medical or social reasons why your child should go to a particular school, you must provide evidence with this application that is supported by a professional (such as a doctor s report). It is very important that you check the admission criteria (arrangements) of each school you are applying for to see if your child can be given priority. Please remember that we only offer places in line with the published admission criteria for each of the schools you list below and not your reasons for wanting that school, unless the schools accept social and medical reasons. School Name (see note 1 above) Sibling s details (see note 2 above) Reasons (see note 3 above) Preference 1 Preference 2 Preference 3 Preference 4 Would you prefer your child to continue going to their current school if we cannot offer you one of your preferences listed? Yes No 6. Parent / Carer Details (if you wish for the application to be discussed with any other person please attach details to the form stating their name, relationship and contact details) Title: Mr Mrs Ms Miss Other First name: Last name: Your relationship to child? Mother Father Step-parent Foster-parent Other family member Please specify If you are not the child s natural parent, please attach documentary evidence that you are the guardian and have parental responsibility for the child named in Section 1 Address: Home phone : Mobile: Your signature: Date: Havering Council will handle information you have provided in line with the Data Protection Act (DPA) and will be used for school admission purposes. The information will be held in confidence with only the necessary people working within the combined children s services able to access and handle it. The Council has a duty under the Children Act 2004 to work with partners to develop and improve services to children and young people in the area. As such, the Council may also use this information for other legitimate purposes and may share information (where necessary) with other Council departments and external bodies responsible for administering services to children and young people. For the purpose of validating proof of address the admissions team may refer to data help by Council Tax records. The Council also has a duty to protect the public funds it administers, and to this end it may use the information you have provided on this form for the prevention and detection of fraud. Under the DPA you have the right to make a formal written request for access to personal data held about you or your child. For further information please contact the School Admissions Team

3 Section B Present or previous school details (this should be filled in and signed by the head of year or head teacher of your child s previous UK school.) The Local Authority may be able to consider this pupil under the LA s Fair Access Protocol if this section is filled in fully. Childs Name: Date transfer form Dates of attendance From was received: at this school: Childs D.O.B: To Attendance: Good Average Poor Attendance (%) If attendance was lower than 85%, please give the reason why. Period Covered Were attendance officers involved? Yes No Special needs: School Support Yes No IEP Yes No Statemented/ EHCP Yes No Common assessment framework (CAF) Has a CAF been carried out or considered? Yes No If Yes, please attach a copy of the CAF. If you do not have a copy, please give the reason why. Other agencies involved (please tick) (Please attach reports or provide details on an extra sheet.) Education Psychologist Service Youth Offending Team Looked after Team Behaviour Support or PRU Child and Family Service Other Education other than at School Traveller Support Service Please add any other comments you think we may find helpful KS4 Students Only: Without these details, it will be difficult for a mainstream school to offer a place late in year 10 or in year 11. Has this child been studying for GCSEs or other KS4 examinations? Yes No Subject Examination board Course code Date course began Where was the course studied

4 Section B (continued) Other support provided Pastoral support plan (dates and comments) Number of days lost due to fixed-term exclusion in the last academic year Has the child been permanently excluded Other Any other important information the receiving school needs to be aware of: To help this child move easily into their future school, please give full contact details below so the school can discuss the above information with you if necessary. Thank you for your help in filling in this form. Your Name: School stamp Your position in the school: Phone (including extension): School name: Local Authority Number : DFE Number: Your signature: Date: Important Information If any of the details about your child change, please tell us immediately in writing. If we can prove that your child has been offered a place based on false, misleading or inaccurate Information, we will withdraw the place. Send us your form in one of the following ways In person: Public Advice & Service Centre (PASC), Liberty Shopping Centre, Romford. By By post: School Admissions Team, Town Hall, Main Road, Romford, RM1 3BD

5 Document Checklist The School Admissions Officer must tick to say that they have seen the relevant documents Proof of Address One document from Group 1 and three documents from Group 2 or at least five documents from Group 2: Group 1 Exchange of contracts / proof of completion showing the parents name and the full address of the property. Legal rental document showing the parents name and the full address and dated for no less than one year with at least 6 months remaining after the application date. Solicitor s letter confirming recent house purchase or land registry confirmation (in this case, proof of the sale or rental of the parents previous address will also be required). Council Tax Bill showing the parents name as a liable person and must be for the current year. Current, valid full UK photo-card driving license with signature or old style driving license. (Provisional licenses are not acceptable as proof of address). The child or parents UKBA Application Registration Card or IND Application Registration Card issued by the Home Office (either are acceptable). UK firearms licence Group 2 Bank, building society statement (not credit card). It must be no more than three months old and show the parents name and current address. Mortgage Statement showing the parents name and current address. Financial Statement eg. Pension, endowment, ISA (UK). Household utility bill (eg. gas, electric, water or fixed line telephone but not a mobile phone bill). It must be no more than three months old and show the parents name and current address. Original notification letter from the relevant benefits agency confirming the right to benefits or state pension showing the parents name and current address. HM Revenue & Customs (Inland Revenue) tax document eg tax assessment, statement of account, notice of coding. It must contain the parent s full name and current address. P45s and P60s are not acceptable. Vehicle Registration Document (V5C) or old style (V5) showing the parents name and current address. TV licence (valid for the current year) showing the parents name and current address. Vehicle tax renewal document (issued within the last 6 months) showing the parent s name. If the family is living with relatives or friends they must provide a letter explaining the situation, if the property is privately rented or a Council property we must see their 2014/15 Council Tax Bill or Council Tax benefit letter or notice with written confirmation from the legal landlord, of all the people who are authorised to live at the premises and for what period of time. The letter must contain the following information: Proof of Identity The address of the property The name of all legal tenants and authorise residents A statement confirming that all people applying for a School place are entitled to stay as permanent residents Birth Certificate or Childs Passport (if new to Havering) Birth Certificate (if new to country) Child Seen In Person (if new to country) Childs Passport (if new to country) Parents Passport (if new to country) Signed: Name Date: / / 20

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