Admissions Form

Pupil’s surname                                                                                                     Male/Female

First names in full

Date of Birth                                                                                                Religion

Home address

Post Code

Home telephone number                                     Work telephone number

Mother’s name       

Mother’s address (if different from above)

Father’s name                                                                     Work telephone number

Father’s address (if different from above)

Name and relationship of person(s) to whom correspondence should be addressed :

Any order relating to the pupil i.e. custody, access etc of which the school should be aware.

Yes    o         No       o                    If yes, please give details on a separate sheet.

Emergency contact numbers during school hours in order of priority:

1.  Name …………………………………….          Relationship ………………….      Tel …………

2.  Name …………………………………….          Relationship ………………….      Tel …………

3.  Name …………………………………….          Relationship ………………….      Tel …………

Pupil’s position in family:

Name of 1^st child …………………………………………………….       Male/Female

Name of 2nd child …………………………………………………….    Male/Female

Name of 3^rd child …………………………………………………….      Male/Female

Name of 4th child …………………………………………………….     Male/Female

Name of doctor                                                                   Telephone Number

Any particular health problems/allergies of which the School should be aware

Lunch arrangements (please tick) School meal   ¨ packed lunch  ¨     go home  ¨

I am entitled to free dinners (please tick box)             Yes  ¨                       No       ¨

Nationality   

First/home language

Name and address of previous school and approximate dates attended.

1.      .………………………………………………………………                                                                                                                                             from …………………….    to …………………………..                                                  

2.      ………………………………………………………………                                                                                                                                                   from ……………………..   to ……………………………                                                               

3.       ………………………………………………………………..                                                                                                                                             from ………………………  to …………………………

If this is your child’s first admission to school, please give name of any nursery or playgroup previously attended.

Mother’s signature …………………………………………………………….. 

Date …………………

Father’s signature ……………………………………………………………..  

Date …………………