• Online Pupil Data Collection Form

  • Child's Details

  •  - -Pick a Date

  • Emergency Contacts

  • Please give details of all persons who have parental responsibility and anyone else you wish to be contacted in an emergency. Due to safeguarding regulations, we must have at least 2 emergency contacts. Please list in the order that you wish them to be contacted. These nominated people would need to be available at short notice in the event of an emergency.

  • Priority 1 Contact


  •  - -Pick a Date

  • Priority 2 Contact


  •  - -Pick a Date

  • Priority 3 Contact


  • Ethnic Background

    Please study the list below and tick one box only to indicate the ethnic background of the pupil or child named above.

  • First Language

  • A first language other than English should be recorded where a child was exposed to the language during early development and continues to be exposed to this language in the home or in the community.

    If a child was exposed to more than one language (which may include English) during early development the language other than English should be recorded, irrespective of the child's proficiency in English.

    In the case of an older pupil who is no longer exposed to the first language in the home, and who now uses only another language, the pupil or parent can determine which language should be recorded.



  • Medical Information

  • Please note that if your child is prescribed medication which needs to be kept in school (ie epi-pen or inhaler) you will need to collect a form from the office and inform the class teacher.

  • Dietary Information


  • Mode of Travel

    Tick the appropriate choice. Where a pupil uses more than one mode of travel for each journey in school, the longest element of the journey by distance should be recorded.

  • Other Information

  • If you or your partner currently receive Universal Credit, Income Support, Income Based Jobseeker’s Allowance, Pension Credit (Guarantee Credit element) or (Income Related) Employment Support Allowance the school may be able to claim extra funding.

  • By completing this form and signing the declaration you are agreeing for Hertfordshire County Council to check whether your child is eligible for PP, EYPP and FSM.  From September 2014 all children who are in Reception, Year 1 or Year 2 in a state-funded school will be offered a free healthy school lunch.  Children in other school years will also be offered a free school lunch if their parent is receiving any of the welfare benefits listed overleaf. 

     

  • Parental Consent

  • Declarations

  • Leavesden Green Primary School collects data and information about parents / carers of our pupils so that we can operate effectively as a school. The schools privacy notice explains how and why we collect parent and carer data, what we do with it and what rights parents have.  If you would like to read our Privacy Notice please go to our school website.

    Before your child joins us we must have received your signed consent forms and a copy of their birth certificate.

    The information I have given on this form is complete and accurate.

    I understand that my personal information is held securely and will be used only for local authority purposes and to pass on to future schools to save it having to be asked for again.

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