In-Year Primary School Application Form: Section 1

In-year Primary School Application Form
The current school continue to track attendance until you have secured another school place
and your child is attending.
Section 1
Pupil Details - Please type on the form and email to us or use clear hand writing print and
post to us
Forename
Surname
Known as
Date of Birth Male Female Year Group
Current Home New/Moving

Address Address
You must provide

proof of address
Date Moving
Current School Last day Attended

school
Has your child been Yes No

permanently excluded?
Please provide the date you would like to start at a new school:
(Please make it clear if you are seeking a place for September start (for
next school year)
Form continues on the next page.

Section 2
Reasons for application
A) Moving into Southend

Please provide moving details and proof of address
B) Moving to a different address in the Southend Area?
Please provide moving details and proof of address
C) Moving to Southend from Overseas
Please provide copy of passport and visa, if you have one
D) Not moving but wanting a new school
Please give the reasons why you are seeking this transfer and confirm if you
have discussed this with the current Head Teacher
Section 3
Parent/ Carers details – please type on the form or use clear hand writing
Mr/Mrs/Miss/Ms Forename Surname
Relationship to Home Telephone no.

child?
Work telephone Mobile telephone no.
no.
Email Address
Section 4
Further details
If you answer yes to any of the below, please ensure to provide a copy of the relevant
documentation
Is your child looked after by a Local Authority or is Yes No

your child previously looked after?
If yes, which Local Authority
Please add your social workers name and contact details
Is your child a member of a Service or Crown Family Yes No
Form continues on the next page.

Section 5
Siblings
If you have another child at any of your preferred schools, please provide their details. If you
are applying for more children please use separate forms for each child.
Name Date of Birth Year Group
Section 6
School Preferences
Please list your preferred school in priority order. You are not required to give reasons for
your preferences; however It would be helpful if any reasons you give relate to published
admission criteria for the school.
Preference Name of Preferred school Additional reasons (optional)
1 Catchment Sibling
Pupil of Staff Other
2 Catchment Sibling
3 Catchment Sibling
Remember to check whether you also need to complete a Supplementary Information Form
(SIF) for any of your schools.
Section 7
Additional information
This information is not used for the admission and provided to the school to support the
placement at the school
Does the child have an Education and Health Care Yes No

Plan/statement?
Is the child currently receiving SEN support in school? Yes No
Does the child have an Individual Support Plan (ISP)? Yes No
Does the child have an Early Health Assessment (EHA)? Yes No
Is the child registered as disabled? Yes No
If you have answered YES to any of the questions above please give details below or an
additional paper;
Have any of the following services been involved with your child in the last three years?
School Attendance Yes No
Educational Psychologist Yes No
Social Worker Yes No
Home Education Yes No
Child and Family Services Yes No
If you have answered YES to any of the questions above please give details below (or on
additional paper) including a contact name and telephone number;
Is your child a young carer? Further information is available on our Yes No

website.
Is there any additional information you wish the admitting school to be Yes No
aware of?
If Yes, please give details below;
Section 8
Submission
In order to provide you with a school place, we will share this information with the necessary
parties.
I am aware of the Primary Admission Booklet as published on the Southend-on-Sea
Borough Council website. I confirm that the information I have given is true and that I have
parental responsibility for this child.
Name: Date
Once completed this General Data Protection Regulation (GDPR) – We are committed to
form must be returned protecting your privacy when you use our services. It is important to us
to; that you can trust us to keep your information safe and to use it in
ways that you will think are reasonable and ethical. Southend-on-Sea
The School Admissions Borough Council are the data controller for the information we have
Team, Department for about you, this means we control how your personal information is
People, Southend on processed and for what purposes.
Sea Borough Council, The School Admissions Privacy Notice, available in full on the council
Civic Centre, Victoria website explains how we use information about you and how we
Avenue, Southend on protect your privacy. We have a Data Protection Officer who makes
Sea, SS2 6ER. sure we respect your rights and follow the law. If you have any
concerns or questions about how we look after your personal
It can also be emailed to information, please contact the Data Protection Officer by email or by
the Admissions Team calling 01702 215000.

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In-year Primary School Application Form

Date of Birth Male Female Year Group

Current Home New/Moving

You must provide

Current School Last day Attended

Has your child been Yes No

Form continues on the next page.

A) Moving into Southend

Mr/Mrs/Miss/Ms Forename Surname

Relationship to Home Telephone no.

Is your child looked after by a Local Authority or is Yes No

If yes, which Local Authority

Please add your social workers name and contact details

Is your child a member of a Service or Crown Family Yes No

Form continues on the next page.

Name Date of Birth Year Group

Preference Name of Preferred school Additional reasons (optional)

Does the child have an Education and Health Care Yes No

Is your child a young carer? Further information is available on our Yes No

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