BLC Student Admission Enquiry Form

(Further details to be taken once place has been agreed)

Student Details:
Surname:
.......................................................................................................................................................................................
Forenames:
.......................................................................................................................................................................................
Date of birth: ...................................................................................................... Gender..
Address: .......................................................................................................................................................................
........................................................................................................................ Postcode: ...........................................

Family Details:
Who has legal parental responsibility for your child? (please circle)
Mother

Father

Mother and Father

Other relation

Carer

Is your child fostered or in the care of the local authority? YES / NO

Does your child hold EEA (European Economic Area) citizenship? Yes / No
If you have circled the No box, please attach a copy of your childs Immigration documents/Passport.

Main Parent/Carer details:

Title: ............ Surname: ....................................................................... Forename: ................................................
Home telephone number: ...................................................... Work telephone number: .....................................
Mobile telephone number: ..................................................... Email:....................................................................
Address (if different from students address above): ............................................................................................
....................................................................................................... Postcode: .........................................................
If the child(ren)/family are moving house, please give address moving to:
..................................................................................................................................................................................
Anticipated date of house move: ...........................................................................................................................
(We may require confirmation of this address at a later date)

Please list brothers, sisters or other relations at BLC:

Names: ....

Year groups: ..

Previous Education
Name and address of Present / Previous School(s)
Name of School:
Address:
1)
2)
Has your child ever had a Statement of Special Needs or Educational Health Care Plan (EHCP) ? Yes/No
Has your child ever been Permanently Excluded from another school? Yes/No

Recent arrivals to UK:

Date of arrival to UK: ................................................................. Country arrived from: .............................................
Other countries your child has lived in: ........................................................................................................................
.
Is the child a member of a family seeking asylum? YES / NO
Is the child a member of a refugee family? YES / NO
Please bring the childs passport / identity document to the admissions meeting.

Communication preferences:
Does the parent/carer need support to communicate in English? YES / NO
If YES, please indicate how:
If INTERPRETER, please give details of an English speaking contact:
Name: ............................................................................................. Relation / friend / other .........................................
Home telephone number: .............................................................. Mobile number: .....................................................

Please tick ethnic heritage / religion:

Ethnic Origin

Religion

Buddhist
White
White and Black African
Christian
British
Any other mixed heritage (please specify below*)
Hindu
Irish
Indian
Jewish
Traveller of Irish Heritage
Pakistani
Muslim
Gypsy / Roma
Bangladeshi
Sikh
White Eastern European
Chinese
No religion
White Western European
Any other Asian heritage (please specify below*)
Any other white heritage (please specify below*)
Black Caribbean
Other (please specify...)
White and Black Caribbean
Black Somali
Other Black African (please specify below*)
White and Asian
*Other:

I confirm that all details given are true and accurate.

Print Name: .
Date: .

Signed: