Edenfield Girls' High School
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Application Form
Child's Details
Full Name*
Date of Birth*
Address
(this should be the address where the pupil lives most of the time)*
Postcode
Ethnicity
First Language*
Other Languages
Special Dietary Requirements
Are there any other professionals involved with the family (speech therapist/social worker)?
YES
NO
Current/Previous Schools Attended
School
Address
School
Address
School
Address
Siblings Details
Please give details of other children in the household of school age or pre-school age
Name
Date Of Birth
School (if any)
Name
Date Of Birth
School (if any)
Name
Date Of Birth
School (if any)
First Parent's Details
First Parent/Guardian Name:
Occupation:
Mobile number:
Address
(if different from pupil’s address above)
If you are not the child’s parent, please specify your relationship to the child:
Second Parent's Details
Second Parent/Guardian Name:
Occupation:
Mobile number:
Address
(if different from pupil’s address above)
If you are not the child’s parent, please specify your relationship to the child:
Child's Medical Details
Important medical conditions (Allergies etc)
Please give details of any specific learning difficulties, special educational needs or disabilities
Child’s Doctor
Address
Emergency Contact Details
Name (person 1)*
Relation (person 1)*
Phone (person 1)*
Name (person 2)
Relation (person 2)
Phone (person 2)
Preferred Start Date
Immediate
Or Month/Year
I give consent for my child to receive any medical treatment that is urgently required