School Transfer Form (Page 2 of 2) in pdf

Other application details

Please tick relevant boxes below

Is the child currently, or have they ever been, in public care (a

Yes

‘Looked After Child’)?

If yes, name the corporate parent

Does your child have a statement of Special Educational Needs

Yes

(SEN)?

If your child does have an SEN statement, which school is

named?

What is your child’s home language?

If applying for a dual stream school, which is your child’s

Welsh

English

preferred language for education?

Has your child ever been permanently excluded?

Yes

Is your child a young carer?

Yes

Please provide any relevant additional information e.g. medical / social reasons for preference:

(special circumstances need to be supported in writing by a medical professional, education professional or registered social worker)

Name and date of birth of one

Name:

Date of birth:

_ _ / _ _ / _ _ _ _

sibling.

If a sibling is also transferring between schools, an additional form needs to be completed.

Details of other adults with parental responsibility even if they live elsewhere:

Title

Full Name

Please note that all adults with parental responsibility

Relationship

should agree to this application. Where appropriate the

to child

Authority will contact a non-resident parent for verification.

Your contact details will not be shared.

Home

telephone

Mobile number

number

Repeat email

address

Address – if same as child, please tick here and leave box below blank

If the address is different, we will use your preferred method

Preferred method of contact

Text

for acknowledging receipt of your application

Declaration:

I confirm that the details above are accurate to the best of my knowledge and belief.

Signature of parent/guardian

Date _ _ / _ _ / _ _

School Admissions,

Customers & Education Support

Denbighshire County Council

Please return your form to:

County Hall

admissions@denbighshire.gov.uk

Wynnstay Road

Ruthin

LL15 1YN

The information requested within this form on pupils, their parents or legal guardians may, in accordance with the Data

Protection Act 1998, be shared with other departments in the local Authority. For further information on how your

information is used and your rights to access the information which we hold on you see the privacy notice on our website

Please note that the Authority reserves the right to request copies of official documentation to verify residence at

the given address. If fraudulent information is given then the local Authority has the right to withdraw the school

place.

School Transfer Form Page 2

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