Student Data Transfer Form
Please note, this form is not an application form for a place at Kingdown School. All applications for places at this school must be dealt with by the School’s Admissions Team at Wiltshire County Council. This form, and the attached medical questionnaire, should be returned to: Primary School or Reception at Kingdown School, Woodcock Road, WARMINSTER, Wiltshire, BA12 9DR.
Date of Admission: September 2017
Student DetailsLegal Surname …………………………..…………………… Legal Forename ……………………..…………….
Middle Name(s) …………………………………………….. Date of Birth …………………………..………….
Preferred Forename …………………………………….…. Preferred Surname …………………………………
Your child’s legal names appear on their Birth Certificate or Passport and whilst we must have a record of them (they must be used for Examination Entries, for example), your child can use a “preferred” name at school. If your child’s name has been changed through adoption or by Deed Poll, we may need to ask to see evidence of this.
Address ……………………………………………………………………………………………………………………………………………….. Postcode…….………………
Is this child Male or Female? Country of Birth ……………………………………….. Nationality ………………………………………………
Ethnicity: White-British or ……………………………….. First/Home Language ……………..…… Religion ……………………………………..
Current/Last School ……………………………………………..…………………………………..
Parents/Guardians Details: Please provide details of both parents (as official record keepers, the Kingdown School must record both parents’ details under the terms of the 1996 Education Act). Where a parent does not live in the same household as a student, copies of school reports will be sent to the non-resident parent if an address has been provided.
Please advise the school if there are any court orders in place which restrict access by either parent to this student.
Mother: Mrs, Miss, Ms (other) : ………… First Name ……………………………………… Surname ……………..………………….………..…….
Address ………………………………………………………………………………………………………….. Postcode……………………………..……….……
Telephone Numbers: Home …………………………….. Work ……………….……………….. Mobile ……………………….…….………..
Email Address……………………………………………………………………………….. Home/Work/Other ……………..………………………..
Important messages are sent directly to parents via email – please provide at least one email address
Occupation …………………………………………………………………… Place of Work …………………………………………………………………….…..
Is this person a serving member of HM Forces? Yes/No Is this person disabled? Yes/No
Does this person require help with communication because of a disability (eg deafness or sight impaired), or because of language issues?
Yes/No ……………………………………………………………………………………………(please give details)
Father: Mr/Other: ….……… First Name ……………………….……………………… Surname ………………….…………..………………….………….
Address ………………………………………………………………………………………………………………………. Postcode…...... ………….
Telephone Numbers: Home ……………………………….….. Work ………………….…………….. Mobile ………………………….…….…………..
Email Address………………………………………………..…………………………………..Home/Work/Other ……………………………….…..…………..
Important messages are sent directly to parents via email – please provide at least one email address
Occupation ……………………………………………………..…………… Place of Work ……………………………………….……………………………….…..
Is this person a serving member of HM Forces? Yes/No Is this person disabled? Yes/No
Does this person require help with communication because of a disability (eg deafness or sight impaired), or because of language issues?
Yes/No ……………………………………………………………………………………………(please give details)
Other Contacts: Please give details of at least one other adult who may be contacted, in an emergency, if the school cannot contact either parent. This person may be another family member, a reliable friend, or a neighbour:
Mr/Mrs/Miss/Ms: ………… First Name ……………………………………… Surname ……..…………………….
Relationship to Student (eg Grandparent/Neighbour etc) …………………………………..……..…………………………..
Address ………………………………………………………………………………………………………………………………………………………… Postcode…...………….
Telephone Numbers: Home ……………………….………….. Work ……………………………….. Mobile …………………………..…………..
Parental Consent
Trips & Visits Consent
I/We give our consent for our son/daughter to participate in school trips and off-site activities during the school day, this includes the Sponsored Walk. Full details of trips/visits will be sent to parents.
Yes/No
Please note the following important information:
1. You can, if you wish, tell the school that you do not want your child to take part in any particular school trip or activity.
2. Written parental consent will not be requested from you for these types of visits.
3. By giving your consent you agree to your child receiving first aid or urgent medical treatment during school trips or activities.
4. You should always keep the school up to date with any medical conditions that your child has.
PE Sporting Fixtures Consent:
I/We give our consent for our son/daughter to participate in school sporting fixtures, (NB Sporting Fixtures will usually be after lessons have finished, and at venues other than the school site).
Yes/No
Youth Support Services
I am happy for the Youth Support Services (schools careers service) to be given my child’s details.
Yes/No
Travel Arrangements:
How will your child usually travel to school (please tick one choice):
Car Share / Car / Cycle/ Dedicated School Bus* / Public Bus Service / Taxi / Train / Walk
*Dedicated School Buses are for entitled students living within the School’s Catchment area.
Meal Arrangements:
At lunch times will your child (please tick one choice):
Have a Free Meal* at school / go Home/ bring Sandwiches or Packed Lunch / buy a School Meal
*If your child is entitled to a Free Meal, please ensure that you complete the relevant forms and return them to the School Nurse at Kingdown School.
School History
Please let us know the names of the schools your child has attended in the past:
Previous Schools
Name / Address / Name / Address
Thank you for completing this information.
Please would you help us by letting us know if any details need to be changed in the future.
This can be either by email to or by letter to Mrs J Saving.
Signature of Parent or Guardian …………………………………………………………..………………… Date ……………………………………………………….
CONFIDENTIAL
Medical Information
Please complete the details below. This form can be returned with the Data Transfer Form to the school. However, if you prefer, please send the completed form directly to the school nurse at Kingdown School. The address is:
The School Nurse
Kingdown School
Woodcock Road
WARMINSTER
Wiltshire
BA12 9DR Telephone: 01985 215551
Please note that any information you may have given to previous schools regarding your child’s health will not be passed on to this school – so please ensure that you let the nurse at Kingdown School know of any medical issues that you think might affect your son or daughter’s schooling.
If your son or daughter has a Health Care Plan, please provide a copy for the School Nurse.
Student’s Name: / Date of Birth:Gender: / Current/Last School:
Surgery Name:
Disability
Is this child disabled?
Medical Conditions:
Please list any Medical Conditions
Medical History:
Please tell us about any relevant medical history or problems
Medicines:
Please tell us about any medicines your child takes regularly
Allergies
Please give details of any allergies which are treated by medicine?
Sight: / Does this student wear glasses? YES / NO
Please give details of any problems with sight
Hearing:
Please give details of any problems with hearing
I understand that I need to keep the School Nurse informed of any changes to my child’s health that may affect their schooling
Signed Parent (or Guardian) ………………………….. Date ………………………
Q/Data/Admissions/Forms/Updated Feb 2016