In Year Application to St James' CE Primary School

Child's Legal First Name and Legal Surname*

Select Gender*FemaleMale

Child's date of birth* Home address including postcode* How long has the child lived at this address?*

School History: It is important that you list in the boxes below your child's full school history, including any schools located outside the UK, and the approximate dates of when your child started and last attended that/those school(s).

School 1 Name\Address\Country and Start and End Dates School 2 Name\Address\Country and Start and End Dates School 3 Name\Address\Country and Start and End Dates

Primary Parent/Carer Title - please select* Primary Parent/Carer Full Name* Relationship to child* Mobile telephone no.* Email address*

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 your child has recently moved to the London area from another part of the UK, please list below the Name of the Borough the child peviously lived and the date of arrival in the London area. If your child has recently arrived in the UK from abroad, please list the date of arrival in the UK, the country from where your child has arrived from and the country which has issued your child's passport.

Is your child travelling on a visa?*YesNo

If your child is travelling on a visa, you must upload a copy of your child's visa documents which can be found in their passport (see upload space below). Please DO NOT send any original documents or passports. No file chosen

Does your child speak English?*YesNo

If no, please state the main language your child speaks. "I would like my child to transfer to another school". You must state your reason(s) below. Please note that your child must remain at their current school until you receive a firm offer of an alternative school place and a start date has been agreed.*

Is your child looked after or were they previously looked after and now adopted or subject to a residence or special guardianship order, immediately following having been looked after?*YesNo

If yes to the above, please state the local authority with whom the child is/was in care and provide documented evidence confirming the legal status of the child. No file chosen

Does your child have a statement of Special Educational Needs (SEN) or an Educational, Health and Care Plan (EHCP)?*YesNo

If yes to the above, you should contact the special educational needs and disabilities team (SEND) in the borough that you live in as children with a statement of SEN or an EHCP are admitted to school using a separate process. Southwark Council's SEND team can be contacted by telephone on 0207 525 4278.

Has your child previously been permanently excluded from a school?*YesNo

If yes, please provide details of all previous permanent exclusions your child has experienced below including school name, postcode and date of exclusion.

DECLARATION : I certify that I have parental responsibility for the child named on this form, that the information is true to the best of my knowledge. I understand and accept that if I have given false or deliberately misleading information on this form and/or any attached supporting papers or withheld any relevant information, the offer of the school place may be withdrawn.*I agree

Please type your name in the box below which will act as your signature on the submission of this form.* Date form submitted*

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In Year Application to St James' CE Primary School

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