Highgate Primary Nursery Admissions Form

Highgate Primary School Nursery Admissions Form

This online Admissions Form is to be completed for the admission of all new Nursery children only.

The information you submit will remain confidential. Details of how the school uses your data can be found on the school website, by looking at the General Data Protection Regulation (GDPR) Policy and Pupil and Parent Privacy Notices.

Please complete this form using lower case letters, e.g. Tom not TOM, with capital letters only where required.

We expect this form to take you approximately 20 minutes to complete.

Please note, you may need information such as National Insurance Numbers for those with parental responsibility, as well as names and contact details of your additional emergency contacts. Please have these before starting the form.

All questions which have an asterisk (*) must be answered. If left unanswered, the Smart Survey will move you to the beginning of the survey again.

Please submit your response by clicking the 'Finish Application' button at the end of the form.

Please note, you will not receive a confirmation of the submission.

Many thanks for your time.

1. Child's Surname/Family Name *

2. Child's First Name *

3. Child's Date of Birth *

	DD/MM/YYYY

4. Child's Country of Birth *

5. Child's Date of Entry If Born Outside of the UK

	DD/MM/YYYY

6. Child's Nationality *

7. Child's Gender Registered on Birth Certificate *

Male
Female

8. Parent's Full Name - Emergency Contact Priority 1
*

9. Address - please note this must be the address where the child normally lives and with the adult who has parental responsibility. A current proof of address e.g. a recent Electric, Gas or Council Tax Bill must be submitted to the Office. *

10. Postcode *

11. Moved In Date *

	DD/MM/YYYY

12. Home Telephone Number

13. Work Telephone Number

14. Mobile Telephone Number *

15. Email Address: *

16. Relationship to Child *

17. Parent's Full Name - Emergency Contact Priority 2 *

18. Address *

19. Postcode *

20. Moved In Date *

	DD/MM/YYYY

21. Home Telephone Number

22. Work Telephone Number

23. Mobile Telephone Number *

24. Email Address *

25. Relationship to Child *

The Pupil Premium is a grant given by the government to schools in England to decrease the attainment gap for the most disadvantaged children, whether by income or by family upheaval. For each child who is eligible, the primary school receives £1455. If you receive any of the following, the school will be able to receive this Pupil Premium funding:

- Income Support
- Income-based Jobseeker’s Allowance
- Income-related Employment and Support Allowance
- Support under Part VI of the Immigration and Asylum Act 1999
- The guaranteed element of Pension Credit * Child Tax Credit (provided you are not also entitled to Working Tax Credit and have an annual gross income of no more than £16,190)
- Working Tax Credit run-on - paid for 4 weeks after you stop qualifying for Working Tax Credit
- Universal Credit - if you apply on or after 1 April 2018 your household income must be less than £7,400 a year (after tax and not including any benefits you get)

Further information on how the school spends the Pupil Premium can be found by clicking here:
https://highgateprimaryschool.co.uk/our-school/pupil-premium-grant

If you believe your circumstances make you eligible for the school to receive this funding the school can check on your behalf.

26. Parent- Contact Priority 1
Please let us know if you believe your circumstances make you eligible for the school to receive this funding. *

Yes- please answer the next question so that the school can check on your behalf
No- please ignore the next question

27. Parent- Contact Priority 1
Please proceed to next question if you do not believe you are eligible.

You can answer this question if you are unsure and the school can check on your behalf.

In order for the school to check on your behalf if your circumstances mean you are eligible for the school to receive the Pupil Premium funding please provide the full name, date of birth and National Insurance Number of the person with parental responsibility who is in receipt of the state benefits.

28. Parent- Contact Priority 2
Please let us know if you believe your circumstances make you eligible for the school to receive this funding. *

Yes- please answer the next question so that the school can check on your behalf
No- please ignore the next question

29. Parent- Contact Priority 2
Please proceed to next question if you do not believe you are eligible.

You can answer this question if you are unsure and the school can check on your behalf.

In order for the school to check on your behalf if your circumstances mean you are eligible for the school to receive the Pupil Premium funding please provide the full name, date of birth and National Insurance Number of the person with parental responsibility who is in receipt of the state benefits.

30. Additional Contact - Full Name - Emergency Priority 3

31. Home Telephone Number

32. Work Telephone Number

33. Mobile Telephone Number

34. Relationship to Child

35. Additional Contact - Full Name - Emergency Priority 4

36. Home Telephone Number

37. Work Telephone Number

38. Mobile Telephone Number

39. Relationship to Child

40. Name of Present/Previous Nursery/Childcare/School *

41. Address of Present/Previous Nursery/Childcare/School *

42. Telephone number of Present/Previous Nursery/Childcare/School *

43. Please provide information of any other children you may have, including their name, age and gender. *

44. Under the current Universal Free School Meals system, every child in Reception, Year 1 and Year 2 in England and Wales is entitled to a free hot lunch. This is regardless of their household income and has been the case since 2014. The Mayor of London has announced that as of September 2023 all junior children (London schools only) will receive a free school meal for the 2023/2024 academic year. Following this academic year, if parents would like a school meal they can sign up their child for a paid school meal. Should there be any changes to this we will inform parents.

Please acknowledge you understand the Universal Free School Meals system, by reading the statements below and ticking both boxes. *

I understand my child is eligible for a free school meal should I want them to have one when they are in Reception, Year 1 and Year 2.
If the Mayor of London's scheme does not continue beyond the 2023/24 academic year, I understand that when my child transfers to Year 3, this may no longer be the case. My child may no longer be eligible for a free school meal unless I am claiming one of the state benefits and I will be charged for the meal should I want them to have a school meal.

45. Is either parent, with parental responsibility, a member of the Armed Forces? *

46. Please indicate if your child belongs to one of the following groups. If your answer is yes, please provide the paperwork to our Designated Safeguarding Lead.
*

Yes - My child has been adopted from care
Yes - My child has left care through special guardianship arrangement
Yes - My child has left care and is subject to a child arrangement order
My child does not belong to any of the above groups

47. Which borough does your child live in?
*

Haringey
Other - Please specify

Details:

48. Name, number & address of Doctor and Medical Practice *

49. Medical Needs and Health Information including any long term plans or medication *

Yes- give details below
No- enter N/A in details

Details:

50. Allergies *

Yes- give details
No- enter N/A in the details

Details: Including medication

51. Special Dietary Needs *

Yes- enter details
No- enter N/A in details

Details:

52. Was your child born: *

Full term - enter N/A in details
Preterm (at 36 weeks or less) - enter details

Details:

53. Does your child have any SEND (Special Educational Needs and Disabilities)? *

Yes - Provide details below (The School SENCO will contact you to discuss further).
No - enter N/A in details
Not Sure - I have some concerns about my child's development please provide details below

Details:

54. Please select which of the following statements is true of your child in relation to Speech and Language Therapy: *

My child is currently receiving speech and language therapy from the NHS
My child has previously received speech and language therapy from the NHS
My child has never received speech and language therapy

55. Please select which of the following statements is true of your child's Communications: *

I have concerns about my child's communication skills.
I do not have concerns abut my child's communication skills.

56. Please select which of the following statements is true of your child in relation to Occupational Therapy and Physiotherapy: *

My child is currently receiving occupational therapy or physiotherapy from the NHS.
My child has previously received occupational therapy or physiotherapy from the NHS.
My child has accessed independent/private occupational therapy or physiotherapy.
My child has never received occupational therapy or physiotherapy.

57. Please select which of the following statements is true of your child's Gross Motor Skills (large muscle and whole body movements) or Fine Motor Skills (small muscle movements usually occur in the body parts such as fingers).
*

I have concerns about my child's Gross Motor Skills.
I have concerns about my child's Fine Motor Skills.
I do not have concerns about my child's Motor Skills.

58. Please tick one box which describes your Child's Ethnic Group *

Details:

59. Please tick one box which describes your child's first language *

Details:

60. Please tick one box which best describes your child's religion *

Details:

61. Home/School Agreement

At Highgate Primary school, we believe that children achieve their best when they are safe, secure, happy and well supported – both at home and at school.

The school will:
• Provide a broad, balanced and rich education that engages all children
• Promote an ethos where all children are valued and diversity is celebrated
• Provide a level of support that enables all children to enjoy their learning and achieve their best
• Take all necessary steps to ensure all children are safe and secure
• Keep parents informed about their child’s progress
• Contact parents if there are any concerns about a child’s learning, wellbeing, attendance, punctuality or behaviour
• Keep parents well informed about school activities and events.

Parents will:
•Ensure that children come to school regularly, providing explanations for all absences.
• Ensure children arrive at school and are collected on time.
• Let the school know about any issues that might affect my child’s learning, behaviour, health or wellbeing.
• Support children at home with reading and homework.
• Attend parent consultation meetings.
• Only book family holidays during school holidays.
• Inform the school promptly of any changes to contact information.
•Notify the school immediately if there is any severe medical condition, particularly where there might be a risk of unconsciousness, e.g. diabetes, epilepsy.
•Discuss any concerns in an appropriate manner, in line with the school’s Complaints Procedures.
• Avoid using mobile phones at pick up and drop off times.
• Follow the school’s Social Media and Social Networking Code of Conduct
• Support the school’s policies and procedures.

School’s Golden Rules:

• Watch and listen to adults, and follow their instructions the first time
• Use words and actions that help and don’t hurt. Always show respect.
• Move around the school safely and quietly
• Take care of school property and other people’s belongings

Social Media and Social Networking Code of Conduct

• All members of the school community are encouraged to engage in social media in a positive, safe and responsible manner at all times.
• Parents should voice any concerns they have through official school channels i.e. with their child’s class teacher, key stage Phase Leader, or with the Headteacher or Deputy Headteacher, not through social media or social networking sites, including WhatsApp groups.
• Other than their own children, parents must only post photographs of pupils when they have the express consent of their parents.
• Parents should not create social media accounts which appear to be endorsed by the school.
• Parents and children should not post malicious or defamatory comments about any member of the school community.
• The school may report any inappropriate comments on social media, including WhatsApp, to the appropriate network and consider legal action if comments are put into the public domain that are libellous, defamatory or are likely to adversely affect the school, pupils and staff.

I agree to abide with the above. *

Agree

62. Termination of the Nursery place.

Due to the long-term commitment we make when reserving a child’s place in our nursery, we must ask you to make a similar commitment to us. We therefore, require a minimum of half a term written notice to withdraw your child from Highgate Primary School Nursery.
If you decide to decline our place before the start of the academic year, or do not give us sufficient notice during the academic year, Highgate Primary School will claim Early Years Free Entitlement Funding for your child for an extra 8 weeks, starting from the first day of the academic year or the day your child leaves us.
*

I fully understand my commitment as per the above

63. I give consent for my child to attend trips that have been planned and risk-assessed by the school.
This will apply for the whole time your child attends Highgate Primary. Should you wish to change this, then email office@highgate-pri.haringey.sch.uk
*

64. I give consent for my child to be photographed or filmed for publicity purposes including newsletter, website, social media and press.
This will apply for the whole time your child attends Highgate Primary. Should you wish to change this, then email office@highgate-pri.haringey.sch.uk.

*

Declaration

I agree to the following terms and conditions:

The information contained on this form is accurate and true. If any of the information changes, I will inform the school in writing.

I understand Highgate Primary School will charge me for any additional services that my child uses beyond the statutory school funded entitlement, i.e Extended Services.

I understand that my child's attendance and punctuality should be regular and that I will inform the school of my child's absence if they are unwell.

I understand that I will be required to give the appropriate notice to the school of my intention to move my child to another setting or leave in order to support effective transition.

I understand that my details will be held securely, in accordance with the principles of the Data Protection Act 2018.

I understand that if I have submitted my National Insurance Number that it will be checked against the national eligibility for Pupil Premium.

If applicable, the person completing this form has discussed all contents submitted to the school with the other person with parental responsibility (if applicable) and they are in agreement with this declaration.

I agree to pay for extended services, school meals and trips when due.

I understand that the school has the right to withdraw provision if my account is not up-to-date.

*

I agree to the terms and conditions.

65. The school needs to know who provided the information on this form.
*

Full Name:	*
Relationship to the child:	*
Date:	*

Highgate Primary Nursery Admissions Form

1. Child's Surname/Family Name *

2. Child's First Name *

3. Child's Date of Birth *

4. Child's Country of Birth *

5. Child's Date of Entry If Born Outside of the UK

6. Child's Nationality *

7. Child's Gender Registered on Birth Certificate *

8. Parent's Full Name - Emergency Contact Priority 1 *

9. Address - please note this must be the address where the child normally lives and with the adult who has parental responsibility. A current proof of address e.g. a recent Electric, Gas or Council Tax Bill must be submitted to the Office. *

10. Postcode *

11. Moved In Date *

12. Home Telephone Number

13. Work Telephone Number

14. Mobile Telephone Number *

15. Email Address: *

16. Relationship to Child *

17. Parent's Full Name - Emergency Contact Priority 2 *

18. Address *

19. Postcode *

20. Moved In Date *

21. Home Telephone Number

22. Work Telephone Number

23. Mobile Telephone Number *

24. Email Address *

25. Relationship to Child *

26. Parent- Contact Priority 1Please let us know if you believe your circumstances make you eligible for the school to receive this funding. *

28. Parent- Contact Priority 2Please let us know if you believe your circumstances make you eligible for the school to receive this funding. *

30. Additional Contact - Full Name - Emergency Priority 3

31. Home Telephone Number

32. Work Telephone Number

33. Mobile Telephone Number

34. Relationship to Child

35. Additional Contact - Full Name - Emergency Priority 4

36. Home Telephone Number

37. Work Telephone Number

38. Mobile Telephone Number

39. Relationship to Child

40. Name of Present/Previous Nursery/Childcare/School *

41. Address of Present/Previous Nursery/Childcare/School *

42. Telephone number of Present/Previous Nursery/Childcare/School *

43. Please provide information of any other children you may have, including their name, age and gender. *

45. Is either parent, with parental responsibility, a member of the Armed Forces? *

46. Please indicate if your child belongs to one of the following groups. If your answer is yes, please provide the paperwork to our Designated Safeguarding Lead. *

47. Which borough does your child live in? *

48. Name, number & address of Doctor and Medical Practice *

49. Medical Needs and Health Information including any long term plans or medication *

50. Allergies *

51. Special Dietary Needs *

52. Was your child born: *

53. Does your child have any SEND (Special Educational Needs and Disabilities)? *

54. Please select which of the following statements is true of your child in relation to Speech and Language Therapy: *

55. Please select which of the following statements is true of your child's Communications: *

56. Please select which of the following statements is true of your child in relation to Occupational Therapy and Physiotherapy: *

57. Please select which of the following statements is true of your child's Gross Motor Skills (large muscle and whole body movements) or Fine Motor Skills (small muscle movements usually occur in the body parts such as fingers). *

58. Please tick one box which describes your Child's Ethnic Group *

59. Please tick one box which describes your child's first language *

60. Please tick one box which best describes your child's religion *

63. I give consent for my child to attend trips that have been planned and risk-assessed by the school. This will apply for the whole time your child attends Highgate Primary. Should you wish to change this, then email office@highgate-pri.haringey.sch.uk *

64. I give consent for my child to be photographed or filmed for publicity purposes including newsletter, website, social media and press.This will apply for the whole time your child attends Highgate Primary. Should you wish to change this, then email office@highgate-pri.haringey.sch.uk. *

65. The school needs to know who provided the information on this form. *

8. Parent's Full Name - Emergency Contact Priority 1
*

26. Parent- Contact Priority 1
Please let us know if you believe your circumstances make you eligible for the school to receive this funding. *

28. Parent- Contact Priority 2
Please let us know if you believe your circumstances make you eligible for the school to receive this funding. *

46. Please indicate if your child belongs to one of the following groups. If your answer is yes, please provide the paperwork to our Designated Safeguarding Lead.
*

47. Which borough does your child live in?
*

57. Please select which of the following statements is true of your child's Gross Motor Skills (large muscle and whole body movements) or Fine Motor Skills (small muscle movements usually occur in the body parts such as fingers).
*

63. I give consent for my child to attend trips that have been planned and risk-assessed by the school.
This will apply for the whole time your child attends Highgate Primary. Should you wish to change this, then email office@highgate-pri.haringey.sch.uk
*

64. I give consent for my child to be photographed or filmed for publicity purposes including newsletter, website, social media and press.
This will apply for the whole time your child attends Highgate Primary. Should you wish to change this, then email office@highgate-pri.haringey.sch.uk.

*

65. The school needs to know who provided the information on this form.
*