2014 secondary school application form

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APPLICATION FOR TRANSFER FROM PRIMARY TO SECONDARY SCHOOLIN SEPTEMBER 2014 (AND HACKNEY UTC FOR YEAR 9 PUPILS ONLY)

Hackney residents should complete this form only. If you live outside Hackney you must complete the form available from the Borough orCounty Council within whose area you live. Please carefully read the guidance notes on the last page before completing the form. Completedforms must be returned to the address shown at the end of the form, by 25th October 2013. If this form is received after the nationalclosing date of 31st October 2013, it will be treated as a late application. There is the easier option of applying on-line, go to:

www.eadmissions.org.uk

1. Childs Details

ChildsFirst Name(s)

Surname/Last Name

Childs Date ofBirth / / Gender Boy Girl

ChildsHome

Address

Post code:Is the above address: Permanent? Yes No

Is the address: Social housing Owner occupier Living with a relative

Private landlord Please provide end date of tenancy agreement ........./........./..........

(This must be the address where the child normally lives between Monday and Friday and where the child benefit is received. If this is differ-ent from the parent/carer address, please give reasons for this. If parents share custody, this must be stated and both addresses shown).

Primary School

(Please also give address if school is outside Hackney)

IF YOUR CHILD HAS A STATEMENT OF SPECIAL EDUCATIONAL NEEDS, PLEASE DO NOT COMPLETE THIS FORM. THE SPECIALNEEDS AND ASSESSMENT TEAM SHOULD HAVE ALREADY SENT YOU A FORM TO COMPLETE.

2. Parents/Carers Details

Parent/Carer 1Title (Please circle) Mr Mrs Miss Ms Other First name

SurnameRelationship

to Childe.g father, mother

State address ifdifferent

(If address is different from childs home address provide reasons for this)

Home Tel no. Mobile Tel E-mail Address

Parent/Carer 2Title (Please circle) Mr Mrs Miss Ms Other First name

SurnameRelationship

to Childe.g father, mother

Home Tel no. Mobile Tel E-mail Address

Please turn over

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Name of secondary schoolBorough or Countyin which school is

located

First name, surname anddate of birth of any

sibling(s) already attendingthe school

Medical/socialreasons

Preference 1

Tick box - ifdocuments are attached formedical/social reasons

Preference 2

Tick box - if

documents are attached formedical/social reasons

Preference 3

Tick box - if


Preference 4

Tick box - if


Preference 5

Tick box - if


Preference 6

Tick box - if


Staff child - Children of staff who work at the school /academy fulltime with at least two years continuous employment by theAcademy or where the Academy reasonably considers a member of staff has been recruited for a position for which there is a

demonstrable skill shortage.Name of staff School / academy name Designation / Role Start date

4. Other info rmationReasons for preferences - Please give the reasons below for your application including any relevant background information, thesemight include religious, philosophical or any other reasons.

Please continue on a separate sheet if necessary.

Exceptional Medical, Social or Other GroundsThese might include religious, philosophical or any other reasons. If you think that there are exceptional medical or social reasons why yourchild should attend a particular school, you must provide professionally supported evidence with this application form. It is very important thatyou check the admission criteria of each school for which you are applying to see if priority of admission can be given on this basis.

Please continue on a separate sheet if necessary.

5. Chi ldren in Care/Subject t o a Chi ld Pro tection PlanThis includ es al l looked after chi ldren andchi ldren who were previously looked after , and are now su bject to an adoption, residence, or special guardianship order.Is this child Looked After by a Local AuthorityIf yes, please complete below:

Is this child subject to a ChildProtection Plan (CPP)?

Local authority Social worker name Contact number Yes No

3. Second ary Scho ol PreferencesPlease write the name of up to SIX schools which you wish to apply to. You mu st l ist the schools in the order you prefer them. Youshould include all state-funded schools, academies and free schools for which you wish to apply, including any schools which are outsideof Hackney. You should include the details of any sibling (brother or sister) who is current lyattending the school below. Applications forprivate fee-paying schools must be made separately, direct to the school.

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Parents/Carers Signature Date: / /

Information supplied will be used for registered purposes under the Data Protection Act 1998.

Checklist:Before returning this form, please ensure that you have:

Read the accompanying notes and the secondary school admissions brochure Hackneys Secondary Schools2014 Admissions Guide for Parents and/or the guide for the borough or county council in which each school forwhich you are applying is located.

Checked that your childs address is within the Borough of Hackney.

Completed all relevant sections of this form.

Enclosed any supporting evidence (e.g. a letter from the family doctor/hospital consultant in support of anymedical or social claim)

Attached the relevant proofs of address (if you have changed address in the last year we

may request further evidence):

The original council Tax Bill for Year 2013/2014 or the original letter for Housing Benefit entitlement

An original utility bill received within the last two months (Gas, Electricity or Landline phone)

Completed supplementary forms MUST BE SENT DIRECTLY TO THE SCHOOL(S) CONCERNED . Pleasecheck the admission arrangements for each school for which you are applying to see if a supplementary form isrequired.

6. Declaration and Signatu re of Parent/Carer

I wish to apply for a place at each of the schools named in Section 3, and I have listed these schools in my orderof preference.

I certify that I am the person with parental responsibility for the child named above who lives in the Borough ofHackney, and that the information given is true to the best of my knowledge and belief.

I understand that any false or deliberately misleading information given on this form and/or supporting informationmay render this application invalid, or lead to the offer of a place being withdrawn.

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GUIDANCE NOTES FOR PARENTS WHO WISH TO COMPLETE THE ATTACHED FORMPUPILS TRANSFER FROM PRIMARY TO SECONDARY SCHOOL IN SEPTEMBER 2014

This form should not be completed in respect of a child who has a Statement of Special Educational Needs

All Hackney residents must complete this form. The national closing date is 31 October 2013, we would prefer allcompleted forms returned to Hackney Learning Trust by 25

thOctober 2013.

Hackney Learning Trust will be operating an Equal Preference system in accordance with the Pan-London AdmissionsSystem, The Pan - London Schools Admissions System is used by all 33 London boroughs together with neighbouringCounties.

All your preferences will get considered at the same time, regardless of its rank and whether the school is in another localauthority.

Section 1Childs DetailsAll sections must be completed.

Section 2Parents/Carers DetailsPlease ensure that the names of all responsible adults/carers are recorded on the form for the secondary school toapproach. Please note that when parents live separately, the application must be based on one address where the childnormally lives between Monday and Friday and where the child benefit is received. You should provide a letter ofexplanation as to the living/care arrangements of your child if the address is different to the address that is normally used.Hackney Learning Trust will withdraw offers of a place if it has been proven that false or misleading information has beenprovided.

Section 3 Secondary School PreferencesYou are entitled to name up to six secondary schools anywhere in London as your expressed preferences on this form(except for private fee paying schools). Please ensure that you complete all the boxes that are applicable to eachpreference.

Sibling Connection - It is important that you state if your child already has a brother or sister including step siblings,(they must be living in the same household/ address between Monday to Friday) attending the preference school, as thiscan give your child priority for admission.

Medical/Social reasons - Special consideration can be given to children who have a particular medical or social need.This will need to be demonstrated by providing professionally supported documentation, and explains why this meansyour child can only attend a particular school. These documents should be attached to this form or sent to us by Monday6th January 2014.

Children of staff working at a schoolSome schools, as part of their criteria give priority to children of staff working intheir school. You will need to provide the member of staff details (who is the parent of the child) on the form in order to beconsidered under this priority.

If applying to Cardinal Pole Catholic, Lubavitch Girls Senior Girls Jewish, The Urswick CE, Our Ladys Covent Catholicand Yesodey Hatorah Girls Jewish Schools you must obtain a supplementary form for religious commitment. Thesupplementary form must be completed by the Priest/Vicar/Pastor/Rabbi and is available directly from either HackneyLearning Trust or the secondary schools. Completed supplementary forms must be sent directly to the school(s)concerned.

Section 4 Other information

Please give reasons for preferences

Please write a supporting statement if you are considering to apply for medical/social priority and include any relevantdocuments. Please note not all schools have this criterion.

Section 5 Children in Care/Subject to a Child Protection

If you are a Foster Carer, looking after a child who is in public care, this must be indicated on the form. Children in thiscategory will be given priority of admission to the community schools in Hackney in accordance with the criteria foradmission. If previously looked after proof of this must be supplied.

Please return this form to: Admissions Team, Hackney Learning Trust, 1 Reading Lane, E8 1GQContact number: 020 8820 7501/7247

RECEIPT

Receipt of application:

Your application has been received by:

......................................................................................................

(To be signed by the Admissions officer receiving the form)

Name of Child ______________________________________

Date of Birth / /

HLT Stamp

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2014 secondary school application form

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