New Starter Form to be completed by parent/carer

My child is starting*St James' SchoolSt James' Nursery

Child's Legal First Name and Legal Surname* Child's Preferred First Name and Surname (if different from above)

Select Gender*FemaleMale

Child's date of birth* Please upload a copy of your child's birth certificate here* No file chosen Child's NHS number (found in NHS "red book")* Language spoken at home* If not English, please comment on your child's level of English speaking. Languages other than English your child understands. Indication of religion - please choose from dropdown list Your Child's Ethnicity - please choose from dropdown list* Previous Nursery/School attended

This section is regarding any medical issues that may apply to your child. This information will be used/consulted by your child's class teacher and teaching assistance to alert them to your child's needs. This information will be shared as described in the school's SDBE UK-GDPR Privacy Notice Primary where applicable.

Medical or Dietary Needs: Select any of the following that may apply to your child. There is an opportunity below to give further information on these, or any other conditions, that may apply.* If your child has been vaccinated against Tetanus, please give the date of vaccination here: Please list here any other medical conditions not listed above and/or give further details about any condition that you have listed above.

If any medical conditions apply to your child, please give more details in the section below.

What is the normal treatment? Will medication be needed in school? Who should be contacted if illness occurs?

Is your child in receipt of Disability Living Allowance?*YesNo

If the answer to the above question on DLA is "yes", please quote the DLA reference number below. This information will allow the school to claim additional funding to aid your child whilst at St James'. Any other relevant information?

Primary Parent/Carer Title - please select* Primary Parent/Carer Full Name* Relationship to child* Primary Parent/Carer Date of Birth*

Are you a British Citizen? If your answer to this question is 'No', please proceed to the next item where you need to upload scanned evidence of your right to remain in the UK, such as a copy of your visa, right to remain documentation, immigration status, etc.*YesNo

If you are not a British citizen, please upload a document here (see above) to provide evidence of your right to remain status in the UK. Please note that without evidence of your right to remain, you will not be able to continue with your application to St James'. No file chosen Primary Parent/Carer National Insurance No.* Primary Parent/Carer Occupation Full Address including postcode* Please upload proof of address document less than 3 months old.* No file chosen Email address* Mobile telephone no.* Home telephone no. Work telephone no.

2nd Parent/Carer Title - please select* 2nd Parent/Carer Full Name* Relationship to Child* 2nd Parent/Carer Date of Birth* 2nd Parent/Carer National Insurance No.* 2nd Parent/Carer Occupation 2nd Parent/Carer Full address including postcode* Email address Mobile telephone no.* Home telephone no. Work telephone no.

Additional Emergency Contact (other family member or friend)* Relationship to Child* Full Name* Full Address including postcode* Mobile telephone no.* Home telephone no. Work telephone no.

DECLARATION : The information I have given on this form is complete and accurate. I understand that my personal information is held securely and will be used only for local authority purposes. I agree to the local authority using this information to process my eligibility for pupil premium. Please see below for a full explanation of this funding.*I agree

Thank you for completing this form and helping to make sure your child’s school is as well funded as possible. The information you have provided here will be used by Southwark Council to establish eligibility to pupil premium which may contribute to funding at your child's school. It may also result in eligible families receiving holiday meal vouchers. Once this is confirmed, this helps to decide how much money your child’s school will receive each year. We are committed to ensuring that the personal and sensitive information that we hold about you is protected and kept safe and secure, and we have measures in place to prevent the loss, misuse or alteration of your personal information. Please see our UK-GDPR Privacy Notices posted on the New Parent Information page. We will use the information you provide to assess entitlement to pupil premium. The information may also be shared with other Council departments to offer benefits and services

Now please complete the Web Publication Consent Form linked to this page (at the top on the right hand side) to inform us of your consent wishes - thank you.

Parents

New Starter Form to be completed by parent/carer

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