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Transition Information Form

Please the enter unique code, this can be found in the Transition letter that was posted to your home address.

Unique code*

Student Information

Surname* Forename* Other name(s) Date of birth*

Gender*MaleFemale

Year group*

Parent/Carer Information

Parent 1

Parent/Carer name* Home address* Postcode* Home telephone number Mobile number* Email address* Relationship*

Primary contact*YesNo

Does the child live at this address?*YesNo

Parental responsibility*YesNo

Parent 2

Parent/Carer name Home address (if different) Postcode Home telephone number Mobile number Email address Relationship

Primary contactYesNo

Does the child live at this address?YesNo

Parental responsibilityYesNo

Legal order

Is there any legal order relating to the child*YesNo

If Yes please provide details

Daytime emergency contacts (if different from parent/carer)

Government guidance requires that we hold information for a minimum of two emergency contacts per child on role

1.Name Relationship Telephone number 2. Name Relationship Telephone number Names of any siblings attending The Basildon Academies

	Name	Year Group

Previous School Doctor's name & address* Doctor's telephone number Medical information – including any food allergies and medication

Consent Providing

Academy Privacy Notices are available on our website.

Photographs/Video

I consent to my child appearing in photos and videos in Academy news articles, website and social media.*YesNo

Name

I consent to my child’s name* appearing in Academy news articles, including electronically *first name and first initial of surname only*YesNo

Lateral Flow Testing

I consent to my child participating in on site lateral flow testing*YesNo

Replacement of Academy Materials

I understand that it will be my responsibility for the replacement of lost or damaged exercise books or other Academy items.Yes

Mobile Phone / Electronic Gadgets

I give my permission for my child to have a mobile phone on their person and understand they are not permitted for use in lessonYes

Biometrics

I consent to my child’s finger print being recorded to make purchases in the Academy dining hall .*YesNo

Free School Meals

Is your child eligible for Free School Meals?*YesNo

If Yes, you will be asked to complete a Free School Meal application form and provide sufficient evidence of entitlement.

Young Carer

Is your child a registered Young Carer?*YesNo

Ethnic details

The Department for Children, Schools & Families have asked us to request and provide them with information relating to the ethnic origin of our students. Would you please assist us by ticking the appropriate box.

Select one of the following Please tick to indicate your child’s mother tongue* If other please specify

Travel

How will your child travel to school?* Date of entry to the UK if from overseas

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