Mariposa Primary School
Application Form for entry in September 2018
Child’s DetailsFamily/Surname / Forename(s)
Middle names / Date of Birth
Year applying for (Reception, Year 1 or Year 3):
Is this an application to start outside the normal year group?
If yes, parents should provide evidence to support the case that the admission outside the normal year group would be in the child’s best interests. This evidence could include a written statement from a doctor, social worker, OFSTED registered childcare provider or other appropriate professional. More detailed guidance can be found on our website or on request.
Please note: for Summer-born children[1] applying to start Reception at 5 years old, no evidence is required. / Yes / No
Please delete as appropriate
Child’s home address
Additional Information
Is the child a ‘Looked After Child’[2]? / Yes / No
Is the child formerly ‘Looked After Child’ but now adopted or, immediately after being looked after, is subject to a ‘Child Arrangements Order’ or ‘Special Guardianship Order’? / Yes / No
If yes, name of responsible local authority
Does the child have exceptional medical, social or other need that Mariposa Primary is particularly able to meet?
If yes, please provide written statement from a doctor, social worker or other appropriate professional (more detailed guidance can be found on our website or on request). / Yes / No
Siblings
Please name any siblings already on roll or any siblings for who you are applying for a place in September 2018
Surname of sibling(s)
Forename of sibling(s)
Date of Birth of sibling(s)
Is this sibling a twin/multiple of the child named in this application? / Yes / No
Parent/Guardian Details
Parent/Guardian 1
Family/Surname / Forename
Address (if different to child’s address)
Telephone Number / Preferred
Alternative / Relationship to child
Email address
Parent/Guardian 2
Family/Surname / Forename
Address (if different to child’s address)
Telephone Number / Preferred
Alternative / Relationship to child
Email address
We only require the details of one parent, but parents may fill in a second parent’s details if they wish.
Please return your form by midnight on 15 January 2018
- By email to
or
- By post to School Admissions, Civic 1, Civic Centre, Harrow, HA1 2UW
Harrow Council are administering the applications process on behalf of Mariposa Primary School.
Information supplied will be used for registered purposes under the Data Protection Act 1998
[1] Summer-born means a child born between 1st April and 31st August, including those dates.
[2] A looked after child is a child who is (a) in the care of a local authority, or (b) being provided with accommodation by a local authority in the exercise of their social services functions (see the definition in Section 22(1) of the Children Act 1989).