17 - Balby Carr
School Application Form 2016/17 Transfers Between Doncaster Schools 2013/14 SECTION A - to be completed by person with parental responsibility If you are using this form to request a move of school for your child, you will need to meet with your child’s present school first. Please complete section A as far as you can and then take it with you to your present school. YOUR CHILD’S DETAILS Surname First name(s) Date of birth
Current year group
Male
Female
Present address including post code Post code If you are moving house write your new address here Post code Your planned moving date
List up to 3 schools in your preferred order 1st Preferred School (normally in your catchment area)
Reason
____________________________________________________________________________________ 2nd Preferred School Reason ____________________________________________________________________________________ 3rd Preferred School Reason For Office/School Use Only
Year Group
SEN Check
CAS 1 / 2 / 3
1st Choice Contact A/L NOR Date
Agreed/Not Agreed
Initials
2nd Choice Contact A/L NOR Date
Agreed/Not Agreed
Initials
3rd Choice Contact A/L NOR Date
Agreed/Not Agreed
Initials
Previous Applications A/L
Allocated School Date HTP
Contact Siblings
NOR Agreed/Not Agreed
Initials CME: Yes / No
Your child’s present school
Start date
Reason for wishing to leave your present school (please be specific and give examples).
How do you intend to get your child to this school
Does your child attend school regularly?
Yes
No
If no please state why:
If one of the above is a church school please complete their additional information form available from the school.
Language
Nationality Is the child
a traveller
an Asylum Seeker or Refugee
a young carer
Do they have a Statement of Special Educational Needs or Education, Health and Care Plan? Yes No If yes, please contact the Special Educational Needs Team for advice (tel 01302 737209). If your child has any significant medical, physical behavioural, emotional or social needs or disabilities, please give details below.
Are they a Looked After Child or one who was previously Looked After*. Yes No Authority Name. ________________________________________________________________ (Include a copy of their Personal Education Plan) *Children previously looked after because they were adopted or became subject to a Residence Order/Child Arrangement Order or Special Guardianship order. Parents/carers will need to submit documents that show this. Please tick the boxes for any of these agencies involved with your child: IFSS
Attendance and Pupil Welfare Service
Social Services
Youth Offending Team
Educational Psychology Service
Other
If you have ticked any of these boxes, please give details: Name of person and Service Contact/arrangements with these services
2
Date of contact
Has your child ever been excluded from school?
Yes
No
If yes please give details Name of school(s)
Reason for exclusion(s)
Date(s) if known
Length(s) of exclusion
Please give details of any previous schools your child has attended over the last 3 years Name of school and date attended Name of school Start date
Leaving date
Leaving date
Leaving date
Reason for leaving
Name of school Start date Reason for leaving
Name of school Start date Reason for leaving
Does your child receive free school meals?
If your child has any siblings at the requested school(s) please give their details below Name and date of birth
School and year group
3
Yes
No
Your Details Mr
Mrs
Ms
Miss
Other
First Name Surname Mother
Father
Carer/Guardian
Other
Your address, if different from your child’s Post code Your contact details Daytime telephone no
Evening telephone no
Email
Declaration I certify that the information on the form is correct. I confirm that all other persons with parental responsibility have been contacted and have agreed to the transfer request. I also confirm that to my knowledge, there are no applications before the courts by a parent, someone claiming to be a parent etc, disputing the child’s residence or which school they should attend. Signed Dated
If you are caring for someone else's child for more than 28 days and are not an immediate family member If youothers are caring for someone child great for more than 28 days are not an immediate family member (but e.g. family friend, else’s neighbour, aunt/uncle, greatand grandparents) you may be private fostering you may be private fostering and you must contact the Local Authority on 01302 373126. More information and you must contact Doncaster Children's Services Trust on 01302 737033. More information is available at is available at www.doncaster.gov.uk/privatefostering www.doncasterchildrenstrust.co.uk/private-fostering What to do next Please contact your present school and arrange for them to complete Section B with you. When this is completed you will need to contact your preferred schools who will complete Section C. Ensure that the school is informed of anyone with parental responsibility relating to the child and about any Court Orders in operation. Once you have visited all schools, if you still wish to make an application, please send via the school or directly to:Admisions and Pupil Services, Doncaster Council, Civic Building, Waterdale, Doncaster, DN1 3BU. s Important Only completed forms will be processed for admission.* * If you are moving into Doncaster - please contact the Admissions Team for further advice. Guidance Unless the request is to be considered as part of our Fair Access Protocol applications received during term time by Friday at 5pm, are normally sent a decision within 2 school weeks. Due to the volume of applications and data protection, no decisions will be given over the phone. When could they start? Normally they are admitted at the start of the next new term and your child must continue at their present school until they start at their new school. Eligibility for admission will be considered using the schools admission policy. If this is a further application, and this is successful, any previous places offered will automatically be withdrawn. A place may be withdrawn if the admission authority is satisfied that the offer was obtained through a fraudulent or intentionally misleading application. Data Protection We need the information we are asking for so that we can consider your request for your child to be admitted to a school. This information is recorded on a computer system and may be shared with other agencies that are involved in the health and welfare of school children. The information about Nationality and language is only used to aid transition into school. 4
SECTION B to be completed by present school with the family Name of member of school staff at the present school completing the form with the family. Name Position
Is this application seeking a managed move on a trial basis of up to 15 weeks?
Yes
If Yes - The School should arrange this directly with the alternative school to complete this form which can then be used at the end of the managed move for the formal admission where the managed move has been successful. Pupil Name UPN Attainment/Teacher Assessments Subject
KS1
KS2
Current NC Level
Teacher assessment/comment
English KS3 Maths Writing KS1/2 Reading KS1/2 ICT Science Phonics
Y1 met*/not met* No.
(out of 40) | Y2 met*/not met* No.
(out of 40)
*Delete
Personalised curriculum details if applicable (please state outcomes/progress) KS4 only Assessment of current performance including most recent assessment results e.g., modular tests and portfolio assessments, including options/personalised learning. Subject
Working at Grade
Estimated final grade
Teacher assessment/comment
Any other comments/recommendations
This year attendance (%)
This year late arrival (%)
Last year attendance (%)
Last year late arrival (%)
5
No
SECTION B to be completed by present school with the family Fixed Term Exclusions Date(s)
Length
Permanent Exclusions Name of excluding school
Date of exclusion
SEN School Action / School Action Plus (with date and outcome of last review)
Behaviour Threshold level (levels over time if appropriate)
1 2 3 4 5
Details of interventions
Outcome
Support agency interventions (with contact name)
Outcome
Any other comments/recommendations
6
SECTION B to be completed by present school with the family Which of the following are you able to provide directly to the receiving school on transfer? (Not to be returned with the application at this stage) Yes / No / N/A
Looked After Child’s Personal Education Plan (PEP)
Pupils with attendance issues Action Plan (AP)
Schools intervention and support given in respect of issues causing concern
Record of referrals to external agencies
SEN Stage, provision of support and involvement of external agencies (if applicable)
Statement of SEN
Pastoral Support Programme and reviews
Individual Education/Behaviour Plan and Reviews
Behaviour/threshold log sheet
Assessment information
Record of Attendance
Record of Parental Interviews / Discussions
Strengths and potential areas for future development - a positive statement detailing the pupils strong points/subject preferences
Child Protection Information
Common Assessment
Declaration Do you support this application?
Yes
No
Please give reasons as you have explained to the parent
Signature
Name
7
Date
Parents must take this form to their chosen school.
SECTION C to be completed by chosen school 1 with the family Pupil’s name School name (first preferred school) Date of meeting with parents and pupil Summary of points raised during discussion eg transport, subject matches, examination entries.
Transport arrangements discussed Any other issues including those which might impact on the success of the move Any other recommendations
Name
Position
Signature
Date
What to do next 1. If the family still wish to make the request to transfer the form should be sent to the Admission Team. If the family still wish to make the request to transfer the form should be sent to the Schools Admission Team. OR 2.Managed Arrange a Move Managed Move - The present school must obtain the agreement of the requested school, complete Tofollowing be completed a managed move agreed with the current school. A copy of the form must be the sectionsifand send a copy of theisform to the Learner Engagement Service. returned to the Learner Engagement Service at the Local Authority. Placement Agreed with family Contract Issued To Parents Attendance Arrangements Confirmed Start date for the trial move Date of interim review Date of final review meeting (within 15 weeks) End date of the trial move (within 15 weeks)
8
Parents must take this form to their chosen school.
SECTION C to be completed by chosen school 2 with the family Pupil’s name School name (second preferred school) Date of meeting with parents and pupil Summary of points raised during discussion eg transport, subject matches, examination entries.
Transport arrangements discussed Any other issues including those which might impact on the success of the move Any other recommendations
Name
Position
Signature
Date
What to do next 1. If the family still wish to make the request to transfer the form should be sent to the Admission Team. If the family still wish to make the request to transfer the form should be sent to the Schools Admission Team. OR 2.Managed Arrange a Move Managed Move - The present school must obtain the agreement of the requested school, complete Tofollowing be completed a managed move agreed with the current school. A copy of the form must be the sectionsifand send a copy of theisform to the Learner Engagement Service. returned to the Learner Engagement Service at the Local Authority. Placement Agreed with family Contract Issued To Parents Attendance Arrangements Confirmed Start date for the trial move Date of interim review Date of final review meeting (within 15 weeks) End date of the trial move (within 15 weeks)
9
Parents must take this form to their chosen school.
SECTION C to be completed by chosen school 3 with the family Pupil’s name School name (third preferred school) Date of meeting with parents and pupil Summary of points raised during discussion eg transport, subject matches, examination entries.
Transport arrangements discussed Any other issues including those which might impact on the success of the move Any other recommendations
Name
Position
Signature
Date
What to do next 1. If the family still wish to make the request to transfer the form should be sent to the Admission Team. If the family still wish to make the request to transfer the form should be sent to the Schools Admission Team. OR 2.Managed Arrange a Move Managed Move - The present school must obtain the agreement of the requested school, complete Tofollowing be completed a managed move agreed with the current school. A copy of the form must be the sectionsifand send a copy of theisform to the Learner Engagement Service. returned to the Learner Engagement Service at the Local Authority. Placement Agreed with family Contract Issued To Parents Attendance Arrangements Confirmed Start date for the trial move Date of interim review Date of final review meeting (within 15 weeks) End date of the trial move (within 15 weeks)
10
1213-426
Current year group
Male
Female
Present address including post code Post code If you are moving house write your new address here Post code Your planned moving date
List up to 3 schools in your preferred order 1st Preferred School (normally in your catchment area)
Reason
____________________________________________________________________________________ 2nd Preferred School Reason ____________________________________________________________________________________ 3rd Preferred School Reason For Office/School Use Only
Year Group
SEN Check
CAS 1 / 2 / 3
1st Choice Contact A/L NOR Date
Agreed/Not Agreed
Initials
2nd Choice Contact A/L NOR Date
Agreed/Not Agreed
Initials
3rd Choice Contact A/L NOR Date
Agreed/Not Agreed
Initials
Previous Applications A/L
Allocated School Date HTP
Contact Siblings
NOR Agreed/Not Agreed
Initials CME: Yes / No
Your child’s present school
Start date
Reason for wishing to leave your present school (please be specific and give examples).
How do you intend to get your child to this school
Does your child attend school regularly?
Yes
No
If no please state why:
If one of the above is a church school please complete their additional information form available from the school.
Language
Nationality Is the child
a traveller
an Asylum Seeker or Refugee
a young carer
Do they have a Statement of Special Educational Needs or Education, Health and Care Plan? Yes No If yes, please contact the Special Educational Needs Team for advice (tel 01302 737209). If your child has any significant medical, physical behavioural, emotional or social needs or disabilities, please give details below.
Are they a Looked After Child or one who was previously Looked After*. Yes No Authority Name. ________________________________________________________________ (Include a copy of their Personal Education Plan) *Children previously looked after because they were adopted or became subject to a Residence Order/Child Arrangement Order or Special Guardianship order. Parents/carers will need to submit documents that show this. Please tick the boxes for any of these agencies involved with your child: IFSS
Attendance and Pupil Welfare Service
Social Services
Youth Offending Team
Educational Psychology Service
Other
If you have ticked any of these boxes, please give details: Name of person and Service Contact/arrangements with these services
2
Date of contact
Has your child ever been excluded from school?
Yes
No
If yes please give details Name of school(s)
Reason for exclusion(s)
Date(s) if known
Length(s) of exclusion
Please give details of any previous schools your child has attended over the last 3 years Name of school and date attended Name of school Start date
Leaving date
Leaving date
Leaving date
Reason for leaving
Name of school Start date Reason for leaving
Name of school Start date Reason for leaving
Does your child receive free school meals?
If your child has any siblings at the requested school(s) please give their details below Name and date of birth
School and year group
3
Yes
No
Your Details Mr
Mrs
Ms
Miss
Other
First Name Surname Mother
Father
Carer/Guardian
Other
Your address, if different from your child’s Post code Your contact details Daytime telephone no
Evening telephone no
Declaration I certify that the information on the form is correct. I confirm that all other persons with parental responsibility have been contacted and have agreed to the transfer request. I also confirm that to my knowledge, there are no applications before the courts by a parent, someone claiming to be a parent etc, disputing the child’s residence or which school they should attend. Signed Dated
If you are caring for someone else's child for more than 28 days and are not an immediate family member If youothers are caring for someone child great for more than 28 days are not an immediate family member (but e.g. family friend, else’s neighbour, aunt/uncle, greatand grandparents) you may be private fostering you may be private fostering and you must contact the Local Authority on 01302 373126. More information and you must contact Doncaster Children's Services Trust on 01302 737033. More information is available at is available at www.doncaster.gov.uk/privatefostering www.doncasterchildrenstrust.co.uk/private-fostering What to do next Please contact your present school and arrange for them to complete Section B with you. When this is completed you will need to contact your preferred schools who will complete Section C. Ensure that the school is informed of anyone with parental responsibility relating to the child and about any Court Orders in operation. Once you have visited all schools, if you still wish to make an application, please send via the school or directly to:Admisions and Pupil Services, Doncaster Council, Civic Building, Waterdale, Doncaster, DN1 3BU. s Important Only completed forms will be processed for admission.* * If you are moving into Doncaster - please contact the Admissions Team for further advice. Guidance Unless the request is to be considered as part of our Fair Access Protocol applications received during term time by Friday at 5pm, are normally sent a decision within 2 school weeks. Due to the volume of applications and data protection, no decisions will be given over the phone. When could they start? Normally they are admitted at the start of the next new term and your child must continue at their present school until they start at their new school. Eligibility for admission will be considered using the schools admission policy. If this is a further application, and this is successful, any previous places offered will automatically be withdrawn. A place may be withdrawn if the admission authority is satisfied that the offer was obtained through a fraudulent or intentionally misleading application. Data Protection We need the information we are asking for so that we can consider your request for your child to be admitted to a school. This information is recorded on a computer system and may be shared with other agencies that are involved in the health and welfare of school children. The information about Nationality and language is only used to aid transition into school. 4
SECTION B to be completed by present school with the family Name of member of school staff at the present school completing the form with the family. Name Position
Is this application seeking a managed move on a trial basis of up to 15 weeks?
Yes
If Yes - The School should arrange this directly with the alternative school to complete this form which can then be used at the end of the managed move for the formal admission where the managed move has been successful. Pupil Name UPN Attainment/Teacher Assessments Subject
KS1
KS2
Current NC Level
Teacher assessment/comment
English KS3 Maths Writing KS1/2 Reading KS1/2 ICT Science Phonics
Y1 met*/not met* No.
(out of 40) | Y2 met*/not met* No.
(out of 40)
*Delete
Personalised curriculum details if applicable (please state outcomes/progress) KS4 only Assessment of current performance including most recent assessment results e.g., modular tests and portfolio assessments, including options/personalised learning. Subject
Working at Grade
Estimated final grade
Teacher assessment/comment
Any other comments/recommendations
This year attendance (%)
This year late arrival (%)
Last year attendance (%)
Last year late arrival (%)
5
No
SECTION B to be completed by present school with the family Fixed Term Exclusions Date(s)
Length
Permanent Exclusions Name of excluding school
Date of exclusion
SEN School Action / School Action Plus (with date and outcome of last review)
Behaviour Threshold level (levels over time if appropriate)
1 2 3 4 5
Details of interventions
Outcome
Support agency interventions (with contact name)
Outcome
Any other comments/recommendations
6
SECTION B to be completed by present school with the family Which of the following are you able to provide directly to the receiving school on transfer? (Not to be returned with the application at this stage) Yes / No / N/A
Looked After Child’s Personal Education Plan (PEP)
Pupils with attendance issues Action Plan (AP)
Schools intervention and support given in respect of issues causing concern
Record of referrals to external agencies
SEN Stage, provision of support and involvement of external agencies (if applicable)
Statement of SEN
Pastoral Support Programme and reviews
Individual Education/Behaviour Plan and Reviews
Behaviour/threshold log sheet
Assessment information
Record of Attendance
Record of Parental Interviews / Discussions
Strengths and potential areas for future development - a positive statement detailing the pupils strong points/subject preferences
Child Protection Information
Common Assessment
Declaration Do you support this application?
Yes
No
Please give reasons as you have explained to the parent
Signature
Name
7
Date
Parents must take this form to their chosen school.
SECTION C to be completed by chosen school 1 with the family Pupil’s name School name (first preferred school) Date of meeting with parents and pupil Summary of points raised during discussion eg transport, subject matches, examination entries.
Transport arrangements discussed Any other issues including those which might impact on the success of the move Any other recommendations
Name
Position
Signature
Date
What to do next 1. If the family still wish to make the request to transfer the form should be sent to the Admission Team. If the family still wish to make the request to transfer the form should be sent to the Schools Admission Team. OR 2.Managed Arrange a Move Managed Move - The present school must obtain the agreement of the requested school, complete Tofollowing be completed a managed move agreed with the current school. A copy of the form must be the sectionsifand send a copy of theisform to the Learner Engagement Service. returned to the Learner Engagement Service at the Local Authority. Placement Agreed with family Contract Issued To Parents Attendance Arrangements Confirmed Start date for the trial move Date of interim review Date of final review meeting (within 15 weeks) End date of the trial move (within 15 weeks)
8
Parents must take this form to their chosen school.
SECTION C to be completed by chosen school 2 with the family Pupil’s name School name (second preferred school) Date of meeting with parents and pupil Summary of points raised during discussion eg transport, subject matches, examination entries.
Transport arrangements discussed Any other issues including those which might impact on the success of the move Any other recommendations
Name
Position
Signature
Date
What to do next 1. If the family still wish to make the request to transfer the form should be sent to the Admission Team. If the family still wish to make the request to transfer the form should be sent to the Schools Admission Team. OR 2.Managed Arrange a Move Managed Move - The present school must obtain the agreement of the requested school, complete Tofollowing be completed a managed move agreed with the current school. A copy of the form must be the sectionsifand send a copy of theisform to the Learner Engagement Service. returned to the Learner Engagement Service at the Local Authority. Placement Agreed with family Contract Issued To Parents Attendance Arrangements Confirmed Start date for the trial move Date of interim review Date of final review meeting (within 15 weeks) End date of the trial move (within 15 weeks)
9
Parents must take this form to their chosen school.
SECTION C to be completed by chosen school 3 with the family Pupil’s name School name (third preferred school) Date of meeting with parents and pupil Summary of points raised during discussion eg transport, subject matches, examination entries.
Transport arrangements discussed Any other issues including those which might impact on the success of the move Any other recommendations
Name
Position
Signature
Date
What to do next 1. If the family still wish to make the request to transfer the form should be sent to the Admission Team. If the family still wish to make the request to transfer the form should be sent to the Schools Admission Team. OR 2.Managed Arrange a Move Managed Move - The present school must obtain the agreement of the requested school, complete Tofollowing be completed a managed move agreed with the current school. A copy of the form must be the sectionsifand send a copy of theisform to the Learner Engagement Service. returned to the Learner Engagement Service at the Local Authority. Placement Agreed with family Contract Issued To Parents Attendance Arrangements Confirmed Start date for the trial move Date of interim review Date of final review meeting (within 15 weeks) End date of the trial move (within 15 weeks)
10
1213-426
