THE OCKENDON ACADEMY AND STUDIO SCHOOL DATA COLLECTION SHEET

Please check that the information below is correct.

Complete any missing details, and return to the school office.

Surname: / Legal Surname:
Forename: / Legal forename:
Middle name: / Gender:
Date of Birth: / Year: / Reg Group:
Address:
Post Code:
Students
Telephone Number:
Students school Email:

Please give details of all persons who have parental responsibility and anyone else you wish to be contacted in an emergency.

Place them in the order that you wish for them to be contacted in an emergency.

Priority / Name/Relationship / Home Address/Phone/Mobile/Fax / Work Address Phone/Email
1 / Tel:
Mobile:
Email: / Tel:
Email:
2 / Tel:
Mobile:
Email: / Tel:
Email:
3 / Tel:
Mobile:
Email: / Tel:
Email:
Please indicate who the learner lives with:
Mother and Father / Mother only / Father only
Mother and Step Father / Father and Step Mother / Other
Please list any brothers or sisters who attend this school:
Ethnicity:
Religion: / First Language:
Country of Birth: / Home Language:
Nationality:
Travel Arrangements
If the above information is incorrect or missing, please tick the appropriate choice
Bicycle / Train / Car/Van / Walk / Taxi / School Bus / Car Share
London Underground / Public Bus Service / Metro/Train/Light Rail / Other
Dietary Needs: This could include, no dairy, Halal, no nuts, gluten free, vegetarian etc.
Dietary Preferences:
School lunches / Free School Meals / Sandwiches / Other

The purpose of the next section of this form is to provide staff with information of your child’s medical conditions (if any), to ensure that he/she can succeed in the school setting.

Doctors Name / Doctors Address / Telephone Number
Medical Condition(s) / Describe the condition, giving details of student’s individual symptoms: / Daily care requirements: / Medication:

ACADEMY POLICIES

Completion of this section is compulsory, please ensure you have read and understood the policies listed below, outlined in the parents welcome letter and on The Academy website.

Policy Approval: / Agree / Disagree
Home – Academy Partnership Agreement
Computer Resources Policy
Permission request for 1. Photography and video
2. Local school trips
Parental signature: / Date:
Date:
Student signature:
For Home – Academy Agreement
Data Protection Act 1998: The school is registered under the Data Protection Act for holding personal data. The school has a duty to protect this information and to keep it up to date. The school is required to share some of the data with the Local Authority and with the DfE. More details regarding this are available on the Academy website and search for privacy notice.