In-Year Admissions Application Form

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Please complete ALL sections in this form IN BLOCK CAPITALS

Incomplete applications will not be able to be processed

Applications will be processed when the appropriate documentation has been received e.g proof of address and birth certificate/passport

Proof of Address that is acceptable is this years financial Council Tax bill or a homeowner document or a tenancy agreement

The official date of application will be when the necessary paperwork has been received.

Applications and queries are processed and acknowledged during term time only - https://www.theglc-lansdowne.org.uk/content/?pid=3&contentid=9

Email *

Section 1: Please indicate the GLC Academies you are applying for in preference order (1 being your first choice) GLC PRIMARY ACADEMY PREFERENCE [Please rank 1 - 4]:

The Gateway Primary Free School

Tilbury Pioneer Academy

Herringham Primary Academy

Lansdowne Primary Academy

Clear selection

Which academic year are you applying for? *

Academic Year 2024 - 2025 (From September 2024)

Section 2: Please indicate the year group you are applying for

Reception

Year 1

Year 2

Year 3

Year 4

Year 5

Year 6

Clear selection

Section 3: Child Information Child's forename: *

Legal surname: *

Middle name(s): *

Preferred surname: *

Date of birth: *

YYYY

Gender: *

Female

Male

Other

Current address - House No. , House name (if applicable), Street, Town, County, Post Code: *

Communication details Home Telephone No: *

Mobile No: *

Email Address: *

Section 4: Moving House

Fill in this section if you are moving house. When are you moving?

YYYY

What will your new address be? House No, House name [if applicable], Street name, Town, County, Postcode

Section 5: Name of school your child attends or previously attended - PLEASE WRITE THE SCHOOL'S FULL NAME *

Address of school including Street, Town, County, Postcode: *

Phone Number of School: *

Date your child last attended: *

YYYY

Year group: *

Section 6: Other Information - Does your child receive support for Special Educational Needs? *

Yes

If YES, does your child hold any of the following: statement of Special Education Needs?

Yes

Clear selection

Education, Health and Care Plan?

Yes

Clear selection

Is the child 'looked after' by a Local Authority?

Yes

Clear selection

Do you have a special guardianship/private fostering arrangement?

Yes

Clear selection

Does your child have any siblings on roll at the GLC? *

Yes

If YES, please provide as much information as possible:

Section 7: I have not moved but would like my child to attend a GLC Academy. Why do you want your child to move school? (Please give as much further information as you can to support your request)

Have any of the following services been involved with your child in the last 3 years? Educational Welfare Officer/ Social Worker/Educational Psychologist/Child & Family Support /Health Visitor/Other? *

Yes

If YES, please tick the appropriate box(s)

Educational Welfare Officer

Social Worker

Educational Psychologist

Child & Family Support

Health Visitor

Other

Clear selection

Did your child attend Early Years Provision? *

Yes

Name and address of Early Years Provision *

Is your child entitled to Pupil Premium (i.e. Free School Meals)? *

Yes

Is your child attending school regularly? *

Yes

If NO, please provide as much information as possible

Section 8: Declaration

If you deliberately give false information, we may withdraw our offer of a place at one of our GLC Academies. All the information I have given on this form is correct. I understand that you may check this information with my child's current/previous school

Yes

Relationship to the child (e.g. Mother/Father/Sibling/Close relation) please specify: *

Has your child ever been permenantely excluded before? *

Yes

Do you have parental responsibility for this child? *

Yes

Your name *

Your signature

Date *

YYYY

I understand applications will be processed when the appropriate documentation has been received e.g proof of address and birth certificate/passport

Proof of Address that is acceptable is this years financial Council Tax bill or a homeowner document or a tenancy agreement

primary.admissions@theglc.org.uk

A copy of your responses will be emailed to the address you provided.

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