MID-YEAR ADMISSION FORM 2015/2016

Transcription

1 Gresham Park Road, West Bridgford Nottingham, NG2 7YF Tel MID-YEAR ADMISSION FORM 2015/2016 As you are applying to a Church of England Academy you are also required to complete the supplementary form attached to this document. You must complete all sections of this form in BLOCK CAPITALS in blue or black ink and return to: Mrs Julie Morley, Director of Student Services The Nottingham Emmanuel School Gresham Park Road West Bridgford Nottingham NG2 7YF jmorley@emmanuel.nottingham.sch.uk 1. About Your Child First Name: Last Name: Gender: MALE / FEMALE Date of Birth: Is your child currently Living in the UK? YES / NO If no, please state the date child will arrive in UK: Child s Address Postcode Date your child moved to this address: If you have moved to this address within the last two months, please give previous address: Child s language spoken at home: Other languages Spoken by child: Present School Name of School: Area of the UK or Country: Date Last Attended:

2 Details of Previous Schools Attended, Including Primary Schools Name of Primary School Date Started Date Left Name of Secondary School Date Started Date Left 2. Support and Information In order to process your application quickly and arrange the right support for your child, please answer ALL of the following questions, as this may give your child higher priority in the admission procedure: 1) Is your child looked after in the Local Authority (in Public Care)? Local Authority responsible for the care of the child (if looked after)? YES NO 2) Does your child have support from a social worker or family support worker? Name and contact details of Social Worker/Family Support Worker 3) Is your child subject to a Child Protection Plan or involved in a Common Assessment Framework (CAF)? 4) Does your child have a statement of Special Educational Needs? 5) Does your child require extra support for behaviour in school? 6) Does your child have any physical/mobility issues? If yes, please give details 7) Is your child attending a Learning Centre or Pupil Referral Unit? 8) Is your child at risk of being permanently excluded from school? 9) Have you withdrawn your child from school because of exclusion or possible Threat of exclusion? 10) Has your child been attending normal lessons in the last month? If no, please give details, including any part time or reduced timetables 11) Has your child attended school regularly in the last 2 years?

3 12) Is your child currently attending school? If no, please provide the date last attended school: 13) Is your child currently being educated at home? 14) Have you completed the elective home education documentation? 15) Have any external agencies supported your child in the last 2 years? If yes, please provide details including names of agencies and dates of involvement 16) Is your child returning from the criminal justice system? 17) Are your family refugees or asylum seekers? 18) Do you consider yourself to be a traveller family? 19) Is your child a young carer? 20) Is your application due to your family fleeing domestic violence? 21) Are you employed as a Crown Servant or UK service personnel? 22) Is your child eligible for Free School Meals? 3. Transfer Requests Why do you want your child to move to another school? Please provide as much detail as you can to support your application (you can add more pages if required) Please inform us of who you have contacted at your child s present/previous school to resolve the issues: Name: Position at school: Date contacted: Name: Position at school: Date contacted: If you have not discussed your issues with your child s current school, we will contact your current school before taking any further action on your application: YOUR CHILD MUST CONTINUE TO ATTEND THEIR PRESENT SCHOOL UNTIL THEY START AT A NEW SCHOOL WHEREVER POSSIBLE.

4 4. Family Details Title: Mr / Mrs / Ms / Miss / Dr / Other (please state) First Name: Last Name: Relationship to Child: Mother / Father / Other (please state) Is your child currently living in the UK? YES / NO If no, please state the date child will arrive in UK: Your Address (if different to child s): Postcode: Mobile Phone Number: Other Contact Number/s: Address: Please provide telephone numbers and address in case we need to contact you about your application. This will help us to contact you quickly if we have a question about your application. By providing your address you consent to us contacting you electronically, including possible notification of decisions. Sibling Details Sibling 1 Full Name: Sibling 2 Full Name: Sibling 3 Full Name: Sibling 4 Full Name:

5 5. Declaration I confirm that: I wish to make an application to The Nottingham Emmanuel School I give consent to my address being verified against Council Tax records where necessary I confirm that I am the person with parental responsibility for the child named in Section 1 and the information is correct to the best of my knowledge and belief I understand that my child s place may be withdrawn if it is proven to have been obtained on the basis of fraudulent or misleading information Parent Signature: Print Name: Date: PLEASE SEE BELOW FOR COMPLETION OF THE SUPPLEMENTARY FORM

6 Gresham Park Road, West Bridgford Nottingham, NG2 7YF Tel SUPPLEMENTARY FORM GUIDANCE INFORMATION 1) Only complete this form if you are applying for a place at The Nottingham Emmanuel School. 2) Please complete the form in block capitals in blue or black ink. 3) Notes of guidance to help you complete this form are in italics. They should be read together with the admissions policy. SECTION A - CHILD DETAILS First Name(s): Surname/Family Name: Date of Birth: Gender: Male / Female Home Address: Postcode: Present School: Name/Address/Telephone/ SECTION B - FAITH COMMITMENT Complete this section if you have a faith commitment. However, it is not essential to have a faith commitment to apply for a place. Give the information on your church or place of worship (where applicable) for both yourself and the child, especially if this is different. Please indicate with ticks which of the following three statements you think applies to yourself and/or to the child. The period in question should normally be for the past two years. Please see guidance set out below the statements. At the heart of the church Yourself Child Attached to the church Known to the church An applicant or child at the heart of the church would be a regular worshipper. This means one who worships usually twice a month. To accommodate difficult patterns of work and family relationships account will be taken of week-day worship. An applicant or child attached to the church may be a regular, but not frequent worshipper, for example one who usually attends a monthly family or church parade service or is regularly involved in a weekday church activity including an element of worship. An applicant or child known to the church may not be a frequent, but probably an occasional worshipper, someone who is known through a family connection, or one or more of whose family is involved in some church activity, such as a uniformed or other church organisation.

7 SECTION B - FAITH COMMITMENT (continued) Please give the name and address of your parish priest, minister or equivalent religious leader who will be contacted by the school to provide a confirmatory statement of your response above. Please give the full name and address as the provision of a reference is central to the applications process. Please note that this application form may be duplicated and forwarded to him or her. Name of Religious Leader(s) Name of Church(es) and / or Place(s) of Worship Tel Number (if known) Address Postcode SECTION C - PARENTAL DECLARATION I/we apply for a place at The Nottingham Emmanuel School for the child named above, in accordance with the information and conditions of admission published by the School Governors. If a place is offered and accepted, I/we undertake to support the school and ensure that the child named above co-operates fully with all the expectations of the school. Signature: Full name of Parent/Carer: Telephone Number(s): Address: Date: PLEASE RETURN THE COMPLETED FORM TO: Mrs Julie Morley, Director of Student Services The Nottingham Emmanuel School Gresham Park Road West Bridgford Nottingham NG2 7YF jmorley@emmanuel.nottingham.sch.uk