Isle of Wight Council

In Year Application for a School Placement Primary School Secondary School This application is for 'in year' admissions only and should NOT be used for a pupil starting school or transferring to secondary school in September Before completing this form we recommend that you read our information booklet 'Educating Your Child' available on http://www.iwight.com/education/admissions/schoolad.asp Parents' / Guardians' Details Your Details as Parent / Guardian 1 Title Mr Mrs Ms Miss other... Please enter your title Forename/s Surname or last name Your relationship to the child Address Building/house name/number Street address Town Name County Postcode Contact Information Home Telephone Number (include area code) Work Telephone Number (include area code) Mobile Telephone Number Email address Second Parents' / Guardians' Details Details of Parent / Guardian 2 Title Mr Mrs Ms Miss other... Please enter their title Forename/s Surname or Last Name Their relationship to the child Second Parents' / Guardians Contact Information Home Telephone Number if different from yours (include area code) Work Telephone Number (include area code) Mobile Telephone Number Email address Second Parents' / Guardians Address Is their address the same as yours Yes No Building/house name/number Street address Town Name County Postcode Childs Details Child's First Name Child's Surname Child's Other Name(s) Gender Male Female Date of Birth Childs Address Is the childs address the same as yours Yes No Building/house name/number Street address Town Name County Postcode Curent School Details Current School Type In Year - Primary School transfer In Year - Secondary School transfer Childs Current School Current year group Year R Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Current year group Year 7 Year 8 Year 9 Year 10 Year 11 If mainland school please provide address and phone number School Phone Number Other Information Does your child have a statement of special educational needs Yes No Is the child in the care of the local authority Yes No Are you applying for a place at any of your preferred schools on medical grounds Yes No If yes to the above question, you should attach or post in a letter from a Consultant Paediatrician or similar, confirming the medical condition and stating why it is essential that your child attends a particular school You will be prompted to attach items to this online form on page 5 Child's Ethnicity How would you describe your child’s ethnic origin White Mixed Asian or Asian British Black or Black British Chinese Other (e.g. South American) White British Irish Any other white background Other: please describe Mixed White and Black Caribbean White and Black African White and Asian Any other mixed background Other: please describe Asian or Asian British Indian Pakistani Bangladeshi Any other Asian background Other: please describe Black or Black British Caribbean African Any other Black background Other: please describe Chinese Chinese Any other Chinese background Other: please describe Any other background, please describe Older Children Do you already have older children living with you who currently attend an Isle of Wight school Yes No First Older Child First Name Surname School Date of Birth Current year group Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Second Older Child Is there another older child living with you and currently attend an Isle of Wight school Yes No First Name Surname School Date of Birth Current year group Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Third Older Child Is there another older child living with you and currently attend an Isle of Wight school Yes No First Name Surname School Date of Birth Current year group Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 More Older Children Are there any other older children Yes No Please give the details of all the older children living with you and attending an Isle of Wight school Your preferred Primary schools Your preferred Secondary schools I would like my child to start school on the following date Please list below the school(s) you wish your child to attend in priority order: You can list up to a maximum of three schools if you wish My first preferred school is Other information I think is relevant. My second preferred school is Other information I think is relevant. My third preferred school is Other information I think is relevant. Decleration Terms and conditions I (we) confirm that all the information on this form is correct and that I (we) have parental responsibility for the child named in Section 1 Where parental responsibility is shared with another person who the child does not ordinarily live with, I confirm that I have made that person aware of this application I (we) understand that the Authority reserves the right to verify the information I (we) have supplied and that any offer of a place based on fraudulent information will be withdrawn I declare that i have read and accept the above terms and conditions and the information I have given on this form is correct and complete I agree I don't agree You can attach relevant files to this online form, or, you can put in the post Attachments Attached Files Please select if you are putting documents in the post Supplementary application form(s) concerning Church Aided Schools (to be sent direct to the school) Other information, e.g. consultant's letter confirming why application for the school applied for is relevant to the child’s medical condition You will be notified of the outcome of your application as soon as we have discussed it with your childs existing and proposed schools. Data Protection Act 1998 Data Protection Act 1998 This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy. Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. Receive Emails If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. Your Information If you wish your non-sensitive personal information to be held by the Council please tick this box Submitting your form Now you should submit your form by pressing the submit button below Your reference number will be provided once submittedThe submission date will set when submitted Reference Number NOT SUBMITTED YET Date Of Submission NOT SUBMITTED YET