Student Admission Form
If you need any help completing this form, or a translated version, please ask the school reception.
Student Details:
Surname: ......
Forenames: ......
Wishes to be known as (e.g. shortened name): ………......
Previous surname (if relevant)......
Date of Birth: ...... Male Female (please select)
Address: ......
...... Postcode: ......
Family Details:
Who has main responsibility for your child? (please select)
Mother / Father / Mother and Father / Other relation / CarerIs your child fostered or in the care of the local authority? YES NO
Who does your child live with? ………………………………………………………………………………………….
(e.g. Mum and partner)
Normally correspondence/school reports are issued to the adult living with the student
who has the main parental responsibility.
If you require additional correspondence/report to be issued to a different contact? Please give details: ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Parent/Carer Information & Emergency Contacts
Contact Priority 1 (Example - Mother)
Title: ...... Surname: ...... Forename: ......
Relationship to child:.…………………………………………………………………………………………….…….
Home telephone number: ...... Work telephone number: ......
Mobile telephone number: ......
Email: ......
Address (if different from student’s): ......
...... Postcode: ......
Parental Responsibility: YES NO
Contact Priority 2 (Example - Father)
Title: ...... Surname: ...... Forename: ......
Relationship to child:…..………………………………………………………………………………………………….
Home telephone number: ...... Work telephone number: ......
Mobile telephone number: ......
Email: ......
Address (if different from student’s): ......
...... Postcode: ......
Parental Responsibility: YES NO
Contact Priority 3 (Example – Grandparent, Step Parent)
Title: ...... Surname: ...... Forename: ......
Relationship to child:....…………………………………………………………………………………………….…….
Home telephone number: ...... Work telephone number: ......
Mobile telephone number: ......
Email: ......
Address (if different from student’s): ......
...... Postcode: ......
Parental Responsibility: YES NO
Contact Priority 4 (Example – Aunt/Uncle, Friend, Neighbour)
Title: ...... Surname: ...... Forename: ......
Relationship to child:…..………………………………………………………………………………………………….
Home telephone number: ...... Work telephone number: ......
Mobile telephone number: ......
Email: ......
Address (if different from student’s): ......
...... Postcode: ......
Parental Responsibility: YES NO
Brothers, sisters or relations at this school:
Name: ………………………………………………………… Year group …………………………………………..
Name:.………………………………………..……………….. Year group .………………………………………..
Previous education in the UK
Name of most recent school: ......
Address: ......
...... Postcode: ………………………………….
Dates from: ...... to: ......
Reason for leaving: ......
…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Name of school: ......
Address: ......
...... Postcode: ………………………………….
Dates from: ...... to: ......
Reason for leaving: ......
……………………………………………………………………………………………………………………………………
Previous education outside the UK
Country/countries where attended formal education: ......
Type of school: ......
Number of years in school: ......
Language of instruction: ......
Further details:…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Recent arrivals to UK:
Date of arrival to UK: ...... Country arrived from: ......
Other countries your child has lived in: ......
Is the child a member of an asylum seeker family? YES NO
Is the child a member of a refugee family? YES NO
Please bring the child’s passport / identity document to the admissions meeting.
Bilingual students
Home Language/s / Literacy level: E=Excellent; G=Good; B=Basic; O=can’t do this yetSpeaking / Understanding / Reading / Writing
1.
……………………………………………………………….. / ……………….. / ……………….. / ……………….. / ………………..
2.
………………………………………………………………. / ……………….. / ……………….. / ……………….. / ………………..
3.
………………………………………………………………. / ……………….. / ……………….. / ……………….. / ………………..
4.
………………………………………………………………. / ……………….. / ……………….. / ……………….. / ………………..
Communication preferences:
Does the parent/carer need support to communicate in English? YES NO
If YES, please indicate how: ……………………………………………………………………………………………….
If INTERPRETER, please give details of an English speaking contact:
Name: ...... Relation to parent/carer…......
Home telephone number: ...... Mobile number: ......
Please tick ethnic heritage / religion:
Child’s Ethnic Origin / Child’s ReligionWhite British / Indian / Christian
White Irish / Pakistani / Buddhist
Traveller of Irish Heritage / Bangladeshi / Hindu
Gypsy / Roma / Chinese / Jewish
White Eastern European / Black Caribbean / Muslim
White Western European / Black Somali / Sikh
White and Black Caribbean / White and Black African / No religion
White and Asian / Other Black African * / I do not want a religion to
be recorded
Other white heritage * / Other mixed heritage *
I do not wish my ethnic heritage to be recorded / Other (Please specify)
*Other (Please specify)
Child’s Nationality
Child’s Country of Birth
Additional Needs: Doctor:
Please give details below of any Special Educational Needs or Disabilities: ………………………………………………………………..…..……………………..…..……………………………………………………………………………………………..…
………………………………………………………………………………………………. / Name of doctor:
………………………………………………….……………..
……………………………………………………………………………………………………………………………………….
Are there any medical conditions which may impact on your child’s
ability to learn?......
……………………………………………………………………………………………...…
………………………………………………………………………………….…………………………………………………………………………………………………………………………… / Address ………………………………………………………………….
………………………………………………………………………….
……………………………………………………….
Telephone number …………………..……………….
Do you believe your child needs to be assessed for any additional needs?
………………………………………………………………………………….……
……………………………………………………………………………………….
………………………………………………………………………………………. / Any medical information (eg allergies)
………………………………………………………………………………………………………………………………………………………………………………………………………………..…………………………………………………………………………
Please continue on a separate sheet if needed
Additional information:
Is either parent serving in H.M. Forces? YES NO
Travel arrangements:
Bus Car Walk Other…………………………………………..
Lunch arrangements:
Paid Lunch Packed lunch Free school meal (authorised) Apply for free school meal
Have Free School Meals ever been claimed since your child first started school? YES NO
Enrichment:
Does your child want to learn a musical instrument? YES NO Undecided - please provide further information: ……………………………………………………………………………………………………………………………….………………….
Does your child play sports for a school team or local team? Please give details: …………………………………………………………………………………………………………………….…………………….………
…………………………………………………………………………………………………………………………………………………..
Does your child attend a supplementary school?......
In previous education has your child been described as “Gifted and Talented”? If so, in what area?
......
· I agree to my child taking part in activities which may be filmed / photographed / recorded by Bristol Brunel
Academy / the media, which may be displayed on our website, in Academy brochures or publicity materials.
· I agree that this information can be used for Essential Information for trips and activities.
· I give permission for any emergency/medical/dental treatment which may be necessary whilst my child is in the
care of the Academy.
· I understand that some data may be shared with relevant staff, the local authority and with the DFE.
· I will inform the Academy of any changes to this information
As part of the Cabot Learning Federation your details may sometimes be shared with other academies within the federation.
Your data may also be used within the Cabot Learning Federation for marketing purposes (for instance, to inform you about opportunities for your child at Post-16). If you would like to opt-out of your information being used for marketing purposes please tick this box:
Opt out of marketing
Form completed by (BBA Staff): …...... Date: …......
Parent /Carer signature: …...... Date: …......