MARLBOROUGH PRIMARY SCHOOL

ADMISSION FORM

For office use
Registration group / House
Admission date / UPN
Legal forename(s) / Legal surname
Preferredforename / Preferredsurname
Date of birthplease provide proof of date of birth / Male / Female
Child’s previous school(s)
Home addressincluding postcode
Date of entry in UK; Date ______or From birth
Names of person(s) with parental responsibility
Carer 1: Mother/Father/Other (please specify)
Mr/Mrs/Miss/Ms/Other (please specify)
Forename / Surname
Mobile telephone / Home telephone
Work telephone / Language
E-mail(please print very clearly)
Address, including postcode (if different to child’s)
Carer 2: Mother/Father/Other (please specify)
Mr/Mrs/Miss/Ms/Other (please specify)
Forename / Surname
Mobile telephone / Home telephone
Work telephone / Language
E-mail (please print very clearly)
Address, including postcode (if different to child’s)
Person to contact in an emergency (other than parent/carer)
Mr/Mrs/Miss/Ms/Other (please specify)
Forename / Surname
Relationship to child / Telephone number
Please give the names of any siblings attending Marlborough Primary School
Free school meals
Children in Reception, Year 1 and Year 2 are automatically entitled to Universal Infant Free School Meals.
Children in any year group across the school may be entitled to means-tested Free School Meals.
Eligible Already in receipt
Emergency consent
In the event of an emergency, if the school is unable to contact me, I give my consent for my child to be taken to hospital for treatment.
Print name: / Date
Signed (Mother/Father)
Dietary needs
Does your child have any special/medical/religious dietary requirements (eg Halal, vegetarian, gluten-free)? If yes, please give details.
Medical (GP) practice
Practice name
Practice address including post code
Practice telephone number
Medical information
Does your child suffer from any medical conditions (eg asthma, eczema, diabetes, hay fever)? If yes, please give details.
Does your child suffer from any allergies? If yes, please give details.
If your child requires any medication to be held in school (eg asthma inhalers, allergy medications), and/or medication to be given during school hours (eg antibiotics, pain-relief) you will need to complete and sign a consent form for each medication, giving full instructions on correct administration. All medicines should be clearly labelled with the child’s name and must be passed to the school’s Welfare Office by a responsible adult, in the container given by the pharmacy.
Ethnic data collection
It is a statutory requirement from the DCFS that we collect ethnic information. Our ethnic origin describes how we think of ourselves. This may be based on many things, including, for example, our skin colour, language, culture, ancestry or family history. Ethnic origin is not the same as nationality or country of birth. Please study the list and tick one box only to indicate the ethnic origin of your child.
White:
□ British
□ Irish
□ Traveller of Irish origin
□ Gypsy/Roma
□ Any other white background
Asian or Asian British:
□ Indian
□ Pakistani
□ Bangladeshi
□ Any other Asian background
□ Chinese / Mixed:
□ White and Black Caribbean
□ White and Black African
□ White and Asian
□ Any other mixed background
Black or Black British:
□ Caribbean
□ African
□ Any other black background
□ Any other ethnic background
□ I do not wish an ethnic background category to be recorded
Additional information
What is the main language spoken at home?
Child’s first language (if different from the above)
Child’s religion
What is your child’s status in this country (eg British citizen, asylum seeker, refugee)?
Child’s country of birth (according to birth certificate)?
Child’s nationality (according to passport)
Service children in education
Is either parent currently serving in the British Armed Forces (Army, Navy or Air Force)? / Yes / No

This Admission Form continues overleaf

Parental consent form

There are various times within school when we need parental consent. These are outlined below, and require your consent in order that your child can participate. This form is valid for seven years from the date you sign it, or for the period of time that your child attends this school. The consent will automatically expire after this time. Please tick the appropriate options and complete the rest of the form before signing and dating.

Yes, I consent to this (please tick)
During their time at Marlborough, children may sometimes leave the school premises as a class, or in small groups, under adult supervision, in order to visit,for example, the library or other local areas of interest.
We will seek separate consent for trips further afield.
Children in Reception, Year 1 and Year 2 are offered fruit and vegetables as a mid-morning snack as part of the Government’s scheme for healthy schools.
Children in Reception are offered a small carton of cow’s milk to drink at school each day.
My child may take part in tasting activities as part of the curriculum.
Classrooms are equipped with interactive whiteboards and teachers may use the internet to enrich the children’s learning. Children access the internet under adult supervision and the school uses filtering systems to ensure the protection of everyone.
DB Primary (the school’s virtual learning environment) is accessed online at school and at home to enhance the learning experiences of children through the provision of a wealth of resources. Children can play games to help their learning, communicate with each other and store their work on-line using this system. Children are frequently reminded by staff to use DB Primary responsibly and are made aware of relevant e-safety issues. All DB Primary activity is monitored by school staff. If any child contributes inappropriate content to DB Primary then they will be subject to disciplinary procedures from the school.
My child is permitted to use DB Primary at home and at school.
Photography
You may use my child’s photograph in the school prospectus or for promotional purposes.
You may use my child’s image on the school’s website.
You may record my child’s image on video or webcam (eg nativity play and family assemblies).
You may use my child’s photograph in the media.
You may use my child’s photograph for assessment and/or display purposes.

Parent/guardian signature ………………………………………………………………………… Date ……………….………………