William Byrd Primary Academy

YOU MUST ANSWER ALL QUESTIONS and PROVIDE ALL REQUESTED INFORMATION. If you do not, your form will be returned to you and your application will be delayed.

Your child's details

Does you child have an Education Health and Care Plan?*YesNo

If YES, please contact the SEN team of the local authority that maintains the Education, Health and Care Plan, as a different statutory admission process applies.

Is your child looked after, or previously looked after, by a local authority (e.g. foster care)?*YesNo

If YES, which local authority? Surname* First name(s)* Date of birth*

Gender*MaleFemale

Address* Postcode*

Does the child or any member of the immediate family have a disability or medical condition, which necessitates a place at your chosen school(s)?*YesNo

If YES, please provide details below, with documented evidence from a health professional/support worker. Please upload documented evidence of disability from a health professional/support worker No file chosen

Your details

First name:* Surname:* Your address (if different from child's) Postcode: Name of local authority to which you pay your council tax: If you are moving or have recently moved house, please provide a date of move Proposed address (if moving) Postcode Home telephone Mobile telephone* Email address:

Do you have parental responsibility of the child?*YesNo

What is your relationship to the child? (e.g. mother, father)

Are you a UK Service Personnel or other Crown Servant applying for a school place as a result of a posting?*YesNo

If YES, please send us a copy of your proof of posting No file chosen

Current education

What is the name of your child's current or most recent school?*

Is your child still attending this school?*YesNo

If NO, please state their last day of attendance What is the date a place is required at the new school Please give your reasons for requesting a new school

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Your child's details

Your details

Current education