Handsworth Primary School

Introduction

Please complete and submit the following forms for every child going to start in Handsworth Primary School or currently in Handsworth Primary School. Please note that only fully completed and validated forms can be submitted. You can save an incomplete form to continue later. Mandotory sections are indicated with a (*)

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Child's Information*

Forename(s)

Surname

Date of Birth

Gender
Male Female

Family Status

Is child a traveller?
Yes No

Main Language

2nd Language

3rd Language

Nationality

Ethnicity

Address
Post Code:

Last school or nursery attended (If not Handsworth Primary School)
Not Applicable Name of School
Address of School
Last date attended

Parent/Guardian 1*

Relationship to the child

Contact Order

I am legally responsible for the child Yes No

Title

Forename(s)

Surname

I receive income support
Yes No

Mobile Phone

Home Phone

Work Phone

Confirm Email

Create Password

Confirm Password

Address As above
Post Code:

Main language

Work Information N/A
Occupation
Workplace Name
Workplace Address
Work hours

-- Save to Submit Later --

Parent/Guardian 2

Relationship to the child

Contact Order

I am legally responsible for the child Yes No

Title

Forename(s)

Surname

I receive income support
Yes No

Mobile Phone

Home Phone

Work Phone

Confirm Email

Create Password

Confirm Password

Address As above
Post Code:

Main language

Work Information N/A
Occupation
Workplace Name
Workplace Address
Work hours

-- Save to Submit Later --

Please provide at least 1 parent/guardian and 2 aditional contacts - OR - 2 parents/guardians and 1 additional contacs

Additional Contact 1*

Relationship to the child

Contact Order

Authorised to collect from school
Yes No

Title

Forename(s)

Surname

Mobile Phone

Home Phone

Work Phone

Confirm Email

Address
Post Code:

-- Save to Submit Later --

Additional Contact 2

Relationship to the child

Contact Order

Authorised to collect from school
Yes No

Title

Forename(s)

Surname

Mobile Phone

Home Phone

Work Phone

Confirm Email

Address
Post Code:

-- Save to Submit Later --

Additional Contact 3

Relationship to the child

Contact Order

Authorised to collect from school
Yes No

Title

Forename(s)

Surname

Mobile Phone

Home Phone

Work Phone

Confirm Email

Address
Post Code:

-- Save to Submit Later --

Additional Contact 4

Relationship to the child

Contact Order

Authorised to collect from school
Yes No

Title

Forename(s)

Surname

Mobile Phone

Home Phone

Work Phone

Confirm Email

Address
Post Code:

-- Save to Submit Later --

Child's School Meal Arrangement*

Child's Brothers & Sisters*

No brothers or sisters

Brother/Sister 1

First Name & Surname

Gender & DOB

School

Class (if in our school)

Brother/Sister 2

First Name & Surname

Gender & DOB

School

Class (if in our school)

Brother/Sister 3

First Name & Surname

Gender & DOB

School

Class (if in our school)

Brother/Sister 4

First Name & Surname

Gender & DOB

School

Class (if in our school)

-- Save to Submit Later --

Protection Orders*

Are there any protection orders issued in relation to the pupil? Yes No

Residence Order
Contact Order

Prohibited Steps Order
Specific Issue Order

Restraining Order

A residence order defines the arrangements to be made as to where, and with whom a child will live. More than one household might be involved, in which case the order will specify the time the child spends in each.
A contact order names anyone who can have contact with the child – who they can visit or stay with, for instance, under such detailed arrangements as the court might determine.
A prohibited steps order forbids specific actions on the part of whoever exercises parental responsibility. Taking the child abroad, may be an example.
A specific issue order settles any matter, possibly of dispute, about the child.
A restraining order is a court order issued by a judge at the end of criminal proceedings to prevent someone from causing harm to someone else, in situations involving domestic violence, harassment, stalking or sexual assault.

-- Save to Submit Later --

-- Save to Submit Later --

Selected Time: _:_

Data Collection Forms

Introduction

Child's Information*

Parent/Guardian 1*

Parent/Guardian 2

Additional Contact 1*

Additional Contact 2

Additional Contact 3

Additional Contact 4

Child's Special Educational Needs (SEND)*

Child's Medical Details*

Child's School Meal Arrangement*

Child's Brothers & Sisters*

Protection Orders*

Agreements*

Diabetes	Yes No
Epilepsy	Yes No
Asthma	Yes No
Visual impairment	Yes No
Hearing difficulties	Yes No

Has grommets	Yes No
Has medically diagnosed allergies	Yes No
Has epipen	Yes No