7/27/2019 Haringey Secondary School Application Form

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First name Last name

Date of birth Gender Boyo Girlo

Childs

address

Current school

Does your child have a Statement of Special Education Needs? Yeso Noo

Is your Child in Care (Looked after Child)? Yeso NooIf yes, state the name ofthe Local Authority

First name Last name

Title Relationship to child

I confirm that I live at the same address as the child, as given above Yeso NooIf No, attach details of your address and why your child does not live with you

Daytime Mobiletelephone number telephone number

Email address

I have parental responsibility for the child named above Yeso Noo

If your child has an exceptional social or medical need to attend a particular school, please name

the school

You must provide supporting professional evidence (see page 6 of the booklet) by 31 October 2013

Childs details Please state information exactly as it appears on your childsbirth certificate

Secondary Transfer Application Form 2014

Haringey Residents ONLY

Application deadline 31 October 2013

Before you apply please: read the Applying for a Place in a Secondary School booklet.

visit the schools you are going to list on the form.

Parent/Carer

Schools

P.T.O.

Addresses are checked andany place gained using a false

address may be withdrawn

Postcode:

We recommend that you apply online at www.haringey.gov.uk/schooladmissions

Only complete this paper form if you are not applying online. PLEASE DO NOT DO BOTH.

7/27/2019 Haringey Secondary School Application Form

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Please list schools in order of preference. You can list schools in Haringey or in any other borough.

*See page 15 of the booklet for information on siblings and multiple births.

If you list a voluntary aided school, foundation school or Academy, you must ensure that youhave completed the schools supplementary information form (SIF) and returned it to the school

direct. You can get the SIF from the school, or from www.haringey.gov.uk/schooladmissions

I confirm that the information I have provided on this form is correct and that I may be asked for further

information to verify that the details given are correct.

Please tick to indicate which photocopied documents you have enclosed:

a) proof of address (two documents required)

o Current Council Tax statement (Council Tax number: )

o Current gas or electricity bill

o Home Office documents

o Current mortgage or rent detailso Current Child Benefit letter

b)o a supporting letter from my childs social worker if my child is in care

c)o supporting professional evidence relating to exceptional social or medical reasons (if applicable)

d)o reasons to support my application (if applicable)

(I understand this information cannot increase the priority of my application unless it relates

directly to the admission arrangements e.g. social/medical).

Signature of parent/carer Date

If you deliberately provide false or misleading information you must expect that the offer of aschool place will be withdrawn.

949.13 09/13

Declaration

DfECode

Full name of school andborough

Name, date of birth and gender of brotheror sister* alreadyattending the school

School 1

School 2

School 3

School 4

School 5

School 6

Please return to Haringey Admissions Service, 48 Station Road, N22 7TYwith proof of your address.Please contact the Haringey Admissions Service on 020 8489 1000 with any queries.Information supplied will be used for registered purposes under the Data Protection Act 1998.