Sixth Form External Admission Form

Please complete the following information:

Student Legal Surname:* Student Legal Forename:* Student Preferred Surname: Student Preferred Forename: Student Middle Name: Student Date of Birth:* Student Address:* Please enter Postcode* Student Mobile Number:* Student Email Address (THIS MUST NOT BE YOUR SCHOOL EMAIL ADDRESS):*

Sixth Form Teams: By giving your consent to use the student email address above you are aware that this will be used to set up a Microsoft Team and that this email address will be visible by other students in the Team. Students do not have to be part of this Team if they don’t want to consent. If a student doesn’t wish to use their current email address for this purpose they could create an email account just for use in this team. More information on how your data is used by Blackfen School can be found on the school website under the GDPR section, link here: https://www.blackfenschoolforgirls.co.uk/page/?title=GDPR&pid=282

I consent*YesNo

If you wish to use a different email address for the Sixth Form Team please state here: (Please do not use your school email address)

Have you ever been a student at Blackfen School?*YesNo

Priority contact 1: Full Name:*

Contact TypeMotherFatherCarerOther

Priority Contact 1: Occupation:* Please enter Address & Postcode of Priority Contact 1 other if different to above: Please enter Mobile Number (Priority Contact 1) :* Please enter Home number (Priority Contact 1) Please enter Work number (Priority Contact 1) Email address Priority Contact 1: This email address will be used for parent communications via Sims In-Touch unless advised otherwise in the Notes section below:* Priority Contact 2: Full Name:*

Contact TypeMotherFatherCarerOther

Priority Contact 2: Occupation:* Please enter Address & Postcode of Priority Contact 2 if different to above: Please enter Mobile number (Priority Contact 2)* Please enter Home number (Priority Contact 2) Please enter Work number (Priority Contact 2) Priority Contact 2: Email address:* Please advise if your child has a sibling at the school please state their name and form: Please give details of any special custody arrangements and provide copies of any court orders etc:

In an emergency, parent’s will be contacted first (Details given above) - Please give full details of any other persons who you wish to be contacted should you not be available, in the order they should be contacted.

Contact 1: Name / Relationship to student / Full address / Contact number Contact 2: Name / Relationship to student / Full address / Contact numbers Please enter Medical Information: Medical Practice Name / Address / Telephone no:* Please enter Health problems/Allergies:

Is your child a young carer:*YesNo

Does your child have an EHCP (Educational Health Care Plan):*YesNo

Does your child have any special educational needs (SEN):*YesNo

Does your child have any Exam concessions:*YesNo

Please give details of all previous schools attended: (most recent first):

	Name of School	Date from	Date to

Consent to photographs of student being used in School Marketing and Press Releases.
Occasionally photos of current students are used in the School prospectus, Newsletter, School Website or information screens and in Press Releases etc. Please advise in the notes section below if you do not give consent.

Ethnicity Questionnaire:
Our ethnic background describes how we think of ourselves. This may be based on many things, including, for example, our skin colour, language, culture, ancestry or family history. The Information Commissioner (formerly the Data Protection Registrar) recommends that young people aged over 11 years old have the opportunity to decide their own ethnic identity. Parents or those with parental responsibility are asked to support or advise those children aged over 11 in making this decision, wherever necessary. Students aged 16 or over can make this decision for themselves.

Religion:

First Language:

Please indicate the language to which your child was first exposed in their early childhood and which they continue to use or be exposed to at home or in your community:*

Additional Information:

Is either parent/carer a member of the Armed Forces*YesNo

Is your child a looked after child (social services)*YesNo

Is your child entitled to Free School Meals*YesNo

Is your child adopted*YesNo

In order to take advantage of offers from universities for first generation graduates it would be helpful if you could confirm the following: Is either parent/carer educated to Degree level.*YesNo

Biometric Consent to the school for the biometrics of my child (please view Biometric information located on the school website under the sixth form form tab/Year 12 Pre admissions)*YesNo

Emergency Closure Arrangements:
In the event of the school having to close early due to bad weather etc, all sixth form students will be SENT HOME.

Parent / Carer’s / Student Undertaking:
In accepting the place offered to my child (named above) at Blackfen School, I and student undertake to abide by the school rules in respect of attendance, behaviour, uniform, photo consent, home & school study, Internet rules and Internet permission and discipline and have read and agreed to the Sixth Form Contract located on the School website under the sixth form tab. Consent to Communication Sent Home via SIMs In Touch: I (Parent/Carer) consent to my contact details to be used for Sims In Touch communications. Internet Permission: I (student) agree to comply with the school’s Acceptable User Policy. I will use the network in a responsible way and observe all the restrictions explained to me by the school. I (Parent/Carer) of the student have read the school’s ‘Student Rules for Internet Use’ and I grant permission for my child to use the Internet outside of lessons for individual research. I understand that they will be held accountable for their own actions. I also understand that some materials on the Internet may be objectionable and I accept responsibility for setting standards for my child to follow when selecting, sharing and exploring information and media. Data Protection: I (Parent/Carer) confirm that I have read the Privacy Notice. Medical form for School Trips (local visits, day visits, evening and sporting activities): I (Parent/Carer) confirm that I have read and understood the medical notice for School trips.
I accept that it is my responsibility to keep the school informed of any changes to the information provided upon admission to the school.

By clicking this box you agree to the terms and conditions as detailed above.*I Student agree

By clicking this box you agree to the terms and conditions as detailed above.*I the Parent/Carer agree

Notes: