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 circle)
Address: ......
...... Postcode: ......
Family Details:
Who has main responsibility for your child? (please circle)
MotherFatherMother and Father Other relation Carer
Is your child fostered or in the care of the local authority? YES / NO
Who does your child live with?
(e.g. Mum and partner)
Usually a single education report is addressed to the adult with main parental responsibility for your child. Do you need an additional report? Please give details:
Mother’s details:
Title: ...... Surname: ...... Forename: ......
Home telephone number: ...... Work telephone number: ......
Mobile telephone number: ...... Email: ......
Address (if different from student’s address above): ......
...... Postcode: ......
Father’s details:
Title: ...... Surname: ...... Forename: ......
Home telephone number: ...... Work telephone number: ......
Mobile telephone number: ...... Email: ......
Address (if different from student’s address above): ......
...... Postcode: ......
Brothers, sisters or relations at this school:
Name:Year group:
Emergency contact numbers to be used if parents are not available:
Contact name 1: ......
Grandparent / neighbour / friend / other ......
Address: ......
...... Postcode: ......
Home telephone number: ...... Mobile number: ......
Contact name 2: ......
Grandparent / neighbour / friend / other ......
Address: ......
...... Postcode: ......
Home telephone number: ...... Mobile number: ......
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: ......
UPN:
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
Languages / Literacy level: E=Excellent; G=Good; B=Basic; O=can’t do this yetSpeaking / Understanding / Reading / Writing
1.Home language/mother tongue:
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 / friend / other ......
Home telephone number: ...... Mobile number: ......
Please tick ethnic heritage / religion:
Ethnic Origin / ReligionWhite / White and Black African / Buddhist
British / Any other mixed heritage (please specify below*) / Christian
Irish / Indian / Hindu
Traveller of Irish Heritage / Pakistani / Jewish
Gypsy / Roma / Bangladeshi / Muslim
White Eastern European / Chinese / Sikh
White Western European / Any other Asian heritage (please specify below*) / No religion
Any other white heritage (please specify below*) / Black Caribbean / Other (please specify...)
White and Black Caribbean / Black Somali
White and Asian / Other Black African (please specify below*)
*Other specified heritage:
I do not wish an ethnic heritage to be recorded
I do not wish a religion to be recorded
Additional Needs:Doctor:
Please give details below of any Special Educational Needs orDisabilities: / 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? YES / NO / Any medical information you would like to let us know (eg. allergies)
Additional information:
Is either parent serving in H.M. Forces? YES / NO
Travel arrangements: eg. car / public transport / walk ......
Lunch arrangements:
Pay for school meal 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
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
I agree to my child taking part in activities which may be filmed / photographed / recorded by Bristol Brunel
Academy / the media, and which may be displayed on our website, in Academy brochures or publicity materials.
I have not withheld any information which may be relevant to my child being offered a place at this Academy
I understand that some data may be shared with the Local Authority and with the DfE.
Form completed by (BBA Staff): ...... Date: ......
Parent /Carer signature: ...... Date: ......
OFFICE USE:
Previous School ContactedStudent Start Date
Uniform
Timetable