Primary School Application form (Late Applications / Late Change Of Preference)

Forename: *

Surname: *

Date of Birth: *

Gender: MaleFemale *

Home Address: *

Postcode: *

Parent/carer's Name: *

Parent/carer's Contact Number: * *

Parent/carer's Email Address: *

Name of person responsible for council tax at this address: *

Name of person who receives Child Benefit: *

Does your child have a statement of special educational needs or education health and care plan? YesNo *

Is your child looked after? YesNo *

If yes, which local authority? *

Name of Social Worker *

Was your child previously looked after? YesNo *

If yes, you need to provide one of the following to the School Organisation Team Adoption Order
Residence Order
Special Guardianship Order *

Please supply any supporting evidence for your application to School Organisation Team, Wigan Council, PO Box 100, WN1 3DS or email schoolplaces@wigan.gov.uk.

Child's current school / nursery *

Armed Forces Personnel Only

Is your relocation due to a new posting? YesNo

Date of new posting: *

If yes, you need to provide a letter from your commanding officer to support this. Please send this to the School Organisation Team, Wigan Council, PO Box 100, WN1 3DS or email schoolplaces@wigan.gov.uk.

Please give details of any brothers or sisters who will be at primary school when your child starts:

Sibling 1

Name: *

DOB:

School:

Sibling 2

Name: *

DOB:

School:

Preference 1

Preference: *

Reason for preference: *

Preference 2

Preference:

Reason for preference:

Preference 3

Preference:

Reason for preference:

The information provided on this form will be processed in accordance with the Local Authority’s School Admissions and Appeals Service Privacy Notice. Information will be treated as confidential and will be used only for the purpose of processing your child’s application for a school place in accordance with the School Admissions Code 2014.

The Privacy Notice is in line with our duties as set out in the Data Protection Act 2018 and GDPR. The legislation gives rights to those individuals whose data is held.

These include:

• The right to request access to the data that is being held by contacting the Council Data Protection Officer – dataprotectionofficer@wigan.gov.uk
• The right to request the reason why the data is being held and what it is being used for.
• The right to request data to be removed (although without the information, your application for a school place cannot be processed).
• The right to request the Local Authority to correct or amend any incorrect information.
• The right to know who the data may be shared with.
• The right to know how long the data can be held before it is destroyed.

A copy of the full Privacy Notice is available by following this link – School Admissions and Appeals Service Privacy Notice.

By submitting your application you are declaring that you have read and understood the terms of the notice.

I confirm that the following is true: I currently live at the address stated; I have parental responsibility for the child and/or the child lives with me; I have read the information booklet 'Applying for a place at Primary School'; all information provided above is correct. *

My relationship to the child is: *

Name of applicant: *

Gender: Please Select --> Male Female *