01323 728 901
office@motcombe.e-sussex.sch.uk
Motcombe Community Infant School - Flying Higher Together
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Admissions Form
Motcombe School Admissions Form
MOTCOMBE SCHOOL ADMISSIONS FORM
Date of Admission (Office Use Only)
CHILD'S DETAILS
Child's Legal Surname
Child's Legal Forename
Child's Preferred Surname (if different from above)
Child's Preferred Forename (if different from above)
Child's Date of Birth
Gender
Male
Female
Please provide other information regarding Gender if necessary
Address
Address Line 1
Address Line 2
Town
County
Postcode
Home Telephone Number
Is this address:
Permanent
Temporary
Child's Previous School Name and Address
Address Line 2
Town
County
Postcode
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Telephone Number
Nursery/Pre-School details (for Foundation Stage children only)
Address Line 1
Address Line 2
Town
County
Postcode
PARENT INFORMATION
PARENT 1 Name: (school information will be sent to this parent)
Parent 1 Mobile Number
Parent 1 Work Number
Parent 1 Email Address
Parent 1 Address
Address Line 1
Address Line 2
Town
County
Postcode
Parent 1 - Parental Responsibility
Yes
No
Parent 1 - National Insurance Number
By completing this information we can check whether your child qualifies for Pupil Premium which gives additional funding to the school to support the children.
Parent 1 - Date of Birth
PARENT 2 Name
Parent 2 Mobile Number
Parent 2 Work Number
Parent 2 Email Address
Parent 2 Address (if different from Parent 1)
Address Line 1
Address Line 2
Town
County
Postcode
Parent 2 - Parental Responsibility
Yes
No
Parent 2 - National Insurance Number
By completing this information we can check whether your child qualifies for Pupil Premium which gives additional funding to support the children.
Parent 2 - Date of Birth
Further Information regarding Parental Responsibility (if applicable):
Does your child have any brothers or sisters attending Motcombe? If yes, please provide their full name/s and date/s of birth.
School receives funding for families who are in the Armed Forces, for Looked After Children, adopted children (UK) and children with a Special Guardianship Order. Please indicate below if this applies to you:
EMERGENCY CONTACTS
Please list your emergency contacts (including yourself) in priority order. Contact 1 - Name
Contact 1 - Relationship to Child
Contact 1 - Telephone/Mobile Number
Contact 2 - Name
Contact 2 - Relationship to Child
Contact 2 - Telephone/Mobile Number
Contact 3 - Name
Contact 3 - Relationship to Child
Contact 3 - Telephone/Mobile Number
Contact 4 - Name
Contact 4 - Relationship to Child
Contact 4 - Telephone/Mobile Number
Please give details of any other adults we should be aware of (eg. step parents/other regular carers)
ADDITIONAL NEEDS
Additional Support - Does your child have an Education, Health and Care Plan (EHCP)?
Yes
No
If your child is receiving extra support at school please provide details
Medical Details
ADHD
ASD
Epilepsy
Asthma
Excema
Hayfever
Dyslexia
Dyspraxia
Colour blindness
Eyesight problems
Hearing problems
Diabetes
Please select any of the above medical conditions your child has.
If there are any other medical conditions that we should be aware of please specify here. (Please provide GP/hospital letter with confirmation of this)
Medication - please provide details of any ongoing medication that your child requires
EMERGENCY TREATMENT
Emergency Treatment - I/we agree to my child receiving emergency hospital treatment should it be considered necessary and to a member of school staff signing the consent form if I am/we are unable to be contacted.
Agree
Do not agree
Doctor's Details
Address Line 1
Address Line 2
Town
County
Postcode
Community Nursing - I agree to my child having Community School Nursing team health checks
Yes
No
DIETARY REQUIREMENTS
Dietary Needs
Vegetarian
Vegan
Pescatarian
No Dairy
Gluten Free
No Eggs
No Dairy
No Pork
No Beef
Nut Allergy (please specify below)
Fruit Allergy (please specify below)
Seafood Allergy (please specify below)
Artificial Colouring Allergy (please specify below)
Please tick if your child has any of the above dietary needs
Please provide further information on dietary needs, if necessary
SUPPORT
Any involvement from external agencies
Speech Therapy
Occupational Therapy
Physiotherapy
Social Worker
CAMHS
Educational Psychology Service
Please provide details of this involvement
ETHNICITY
Pupil's First Language (the language your child speaks most fluently)
Parent 1 - First Language
Parent 2 - First Language
Language spoken at home
Religion
Please select one:-
White
British
Irish
Gypsy/Roma
Traveller of Irish heritage
Any other White background
Mixed
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed background
Other group (please specify)
Black or Black British
Caribbean
African
Any other Black background
Asian or Asian British
Indian
Pakistani
Bangladeshi
Any other Asian background
Chinese
Prefer not to say
Are you Asylum Seekers
Yes
No
Are you Travellers
Yes
No
FURTHER INFORMATION
Please provide all addresses your child has lived, prior to your current address. Please also provide dates.
Address 2
Address Line 1
Address Line 2
Town
County
Postcode
From:
To:
Reason for Moving:
Address 3
Address Line 1
Address Line 2
Town
County
Postcode
From:
To:
Reason for Moving:
Address 4
Address Line 1
Address Line 2
Town
County
Postcode
From:
To:
Reason for Moving:
Please list any other Nurseries/Schools attended (if applicable) with dates
Nursery/School Name
Address Line 1
Address Line 2
Town
County
Postcode
From:
To:
Nursery/School Name
Address Line 1
Address Line 2
Town
County
Postcode
From:
To:
Nursery/School Name
Address Line 1
Address Line 2
Town
County
Postcode
From:
To:
ANY OTHER INFORMATION
If there is any other information you wish to share with us (including involvement from outside agencies due to child protection/safeguarding issues) please provide it here.
PARENTAL CONSENT
These are areas where we require your consent to be registered on our system. Please read the information and tick the boxes for each section as appropriate. This consent will remain in force while your child is at Motcombe School unless it is specifically withdrawn by the parent.
School Trips/Educational Visits
Yes
No
Throughout each academic year we take children out of school on educational visits which could involve a walk to the park, a visit to the theatre or a coach trip a little further afield. We will inform you of these trips as and when they arise and may also request a voluntary contribution towards the cost. Do you give your consent for your child to participate in these visits?
Using Images of Children
Yes
No
Occasionally we may take photographs or video of the children at our school to go on our newsletter and the school website. These images may also be shared on Tapestry (Foundation Stage) and Class Dojo (KS1). Do you consent to your child be photographed or recorded for the above use?
Social Media
Yes
No
Do you give permission for your child's photograph or video to be on our social media pages - Facebook and Instagram?
Community Nursing
Yes
No
The Community Nursing Service will automatically offer your child a hearing, vision and growth assessment within their first year of full-time education. Do you consent to your child being seen by the School Health Team?
Thrive Assessment
Yes
No
Our staff are trained in the Thrive Approach. Every child needs to feel valued, involved and appreciated. We know more now than ever before about what helps to develop healthy curious minds and happy confident and creative children. The Thrive Approach helps us to understand how we develop socially and emotionally from birth to adulthood. It helps us understand what healthy child development looks like in terms of behaviour and learning. It allows us to interpret children's behaviour and identify particular developmental needs being signalled by their behaviour. It provides appropriate, targeted interventions designed to meet those needs. Do you consent to your child having this assessment and Thrive intervention if necessary?
TAPESTRY - Foundation Stage Only
In Foundation Stage we use an online Learning Journey provided by Tapestry and the Early Years Foundation Stage Forum. As this is an online profile, we will need your permission to set up your child's account. Please rest assured that the information about your child and their learning is secure and is only accessible by the members of staff and yourselves as parents. There may be instances where your child appears in a photograph documenting another child's learning.
Do you consent to your child having a Tapestry Online Learning Journey?
Yes
No
Do you consent to your child's image appearing in photographs/videos in other children's Learning Journey?
Yes
No
Class Dojo - KS1 only
ClassDojo is a school communication platform that teachers, students, and families use every day to build close-knit communities by sharing what's being learned in the classroom home through photos, videos, and messages.
Do you consent to your child having a Class Dojo account?
Yes
No
Do you consent to your child's image appearing in photographs/videos in other children's learning?
Yes
No
Do you agree not to electronically share, by social media or other platforms, any part of your child's learning?
Yes
No
Do you agree to the information we have on record for your child being forwarded to their next school when they leave Motcombe.
Yes
No
Parental Declaration - please sign by putting your name in this box
The details supplied on this form are correct to the best of my knowledge. I understand that the Headteacher must be informed of any changes which might affect my child's education.
Data Protection - Personal information will be held and processed by the school in accordance with the Privacy Notice available here: http://motcombe.e-sussex.sch.uk/wp-content/uploads/2020/03/Motcombe-Data-Protection-policy-for-schools-1.pdf
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Contact Us
If you would like to speak to us, or for more information, please contact us via the main school reception by telephone on
01323 728 901
or via email at
info@motcombe.e-sussex.sch.uk
so we can direct you to the appropriate member of staff.