Prep Pupil Information and Contact Form

Prep Pupil Information and Contact Form
Child's Name*

First NameLast Name
Year Group your child will be joining*
Religion*
Enter None if not applicable or you do not wish this to be recorded
Parent 1*
Title
First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this the child's main address?*

YESNO
Parent 1 phone number*
Parent 1 alternative number
Parent 1 email*
Parent 2
Title
First NameLast Name
Does parent 2 live at the above address?

YESNO
Parent 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this the child's main address?*

YESNO
Parent 2 phone number
Parent 2 alternative number
Parent 2 email
Emergency Contact

Details in case of emergency and if parents are not available.
Name*

First NameLast Name
Phone number*
Relationship to pupil*
Languages
What is your child's first language?*
Which languages are spoken at home?
If English is not your child's first language, how long have they studied English?
Have they taken any CEFR (Common European Framework of Reference for Languages) or other ESL (English as a second language) exams?
Ethnicity
The Department for Education (DfE) require us to record details with respect to the ethnicity of pupils. 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. Ethnic background is not the same as nationality or country of birth. 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.

Pupils aged 16 or over can make this decision for themselves. Please study the list below and tick one box only to indicate the ethnic background of the pupil or child named above.

From time to time the information will be passed on to the Local Education Authority and the DfE to contribute to local and national statistics. The use of these statistics will not allow individual pupils to be identified.
Nationality*
White*

British (English, Welsh, Scottish, Northern Irish)IrishGypsy or Irish TravellerRomaAny other white backgroundNone of these
Mixed or multiple ethnic groups*

White and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed or multiple ethnic backgroundNone of these
Asian or Asian British*

IndianPakistaniBangladeshiChineseAny other Asian backgroundNone of these
Black, Black British, Caribbean or African*

CaribbeanAfricanAny other Black, Black British, African or Caribbean backgroundNone of these
Other ethnic group*

ArabAny other ethnic groupNone of these
I do not wish an ethnic background to be recorded
This information was provided by*

ParentPupil
Date*

DayMonthYear
Date
Signature*

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Prep Pupil Information and Contact Form

Emergency Contact

Languages

Ethnicity