SIF 2012

Pupil Information
Full Name of Child

First NameMiddle NameLast Name
Date of Birth

DayMonthYear
Gender
Home Information

Parent 1/Carer 1 Details
Full Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Daytime Contact Number

Area CodePhone Number
Home Information

Parent 2/Carer 2 Details
Full Name

PrefixFirst NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Daytime Contact Number

Area CodePhone Number
Siblings at St. Edmund's
Siblings currently attending St. Edmund's at time of entry
Full Name

First NameLast Name
Year
Religion
Child's Religion
Failure to complete the Supplementary Information Form may affect your child's chances of gaining a place at the school
My child is..
Church you attend
Church Commitment

On becoming a member of the School, parents and families are encouraged to participate as fully as possible in the wider family of the Church.
Other Information
Please add here any other information you may feel is relevant to this application in relation to the school's admissions policy in respect of exceptional medical, social or pastoral needs of your child that make only this school suitable for them. Strong and relevant evidence must be provided by an appropriate professional authority (eg qualified medical practitioner, education welfare officer, social worker or priest).
Should be Empty:

Pupil Information