1. On-Line Admission Form

Child's First Name.* Child's Surname* Preferred First Name Preferred Surname* Gender* Date of Birth* Nationality (optional) Country of Birth (optional) Date of entry to the country Address* Post Code*

Special Educational Needs

Does your child have Special Educational Needs or hold an Educational Health Care Plan (EHCP)?*

Previous School / Nursery

Name of School / Nursery Start Date Finish Date School / Nursery Address

Languages

Languages Spoken
Please list the languages spoken by the child and whether they are a first, second, home or tuition language.

First Language* Second Language Home Language Tuition

Religion

Religion*

Dietary / Medical Information

Pupil Premium: Free School Meal Eligibility Is this child eligible for free school meals?* Free School Meal Claimant If eligible, would you like to claim free school meals for this child? Dietary Requirements Does this child have any special dietary requirements? E.g. vegetarian, halal, celiac, severe allergies All known disabilities Doctors Surgery / Practice Name Diagnosed Medical Conditions* Further Details Doctors Surgery / Practice Address

Ethnicity

White Asian or Asian British Black or Black British Mixed Other / None

Family Details and Living Situation

‘Looked after’ Status* Family Situation* Family In School Protection Register Status* Sibling Protection Register Status* Traveller Status* Refugee Status* Armed Forces*

Primary Emergency Contact 1 (Parent / Carer)

Full Name* Gender* Relationship* Armed Forces* Other Children At Nova National Insurance Number / Nass Number* Contact 1 - Date of Birth* Contact 1 - Language Spoken* Permission to take home* Parental Responsibility* Address same as childs* Address if different from childs (please include door number and postcode). Home Telephone Number Work Telephone Number Place of Work / Address Mobile Number* Email Address

I consent to being contacted about/receiving school-related marketing, extracurricular and fundraising information. This may include PTA events, newsletters, before/after school clubs, educational brochures, products and local workshop information that may be of interest to you or your child. Consent may be withdrawn by contacting the school office.

Consent*

Primary Emergency Contact 2 (Parent / Carer)

Full Name Gender Relationship Armed Forces Please provide names of any children already attending Nova Primary Academy.. National Insurance Number / Nass Number Contact 2 - Date of Birth* Permission to take home Parental Responsibility Address same as childs Contact Address Home Telephone Number Work Telephone Number Place of Work / Address Mobile Number Email Address

Consent*

Contact 1 & 2 Declaration

General Data Protection Rules 2018 (GDPR): The school is registered under the Data Protection Act for collecting, storing and processing personal data. The school has a duty to protect this information and to keep it up to date. The information collected within this form will be used to register your child at Nova Primary Academy. The personal data we hold may be shared with:
• The Department for Education and other relevant organisations whom they nominate.
• Local Education Service and any other Local Education Authorities with whom the child becomes associated.
• Schools and Further Education establishments with whom the child becomes associated.
• Recognised health care and social work establishments with whom the child may become associated.

Privacy Notice
Further information can be found within our privacy notice, which is available on our website, at: https://www.novaprimaryacademy.co.uk/page/?title=Gdpr, website use and freedom of information&pid=68

Parent / Carer 1

The information I have provided within this form is accurate and up to date.* I have read and understood the information provided within Nova's privacy notice.* FullName* Date*

Parent / Carer 2

The information I have provided within this form is accurate and up to date. I have read and understood the information provided within Nova’s privacy notice. Full Name Date