KLA Admissions Form

Details of Student

Legal Surname* Legal First Name* Middle Name Preferred Surname Preferred First Name Date of Birth* Gender* Address* Postcode* Siblings attending KLA if applicable (Name and Year)

Details of Parents/Carers Living at the home address who have parental responsibility

Title
	Parent 1	Parent 2

Surname
	Parent 1	Parent 2

First Name
	Parent 1	Parent 2

Relationship to Student
	Parent 1	Parent 2

Mobile Number
	Parent 1	Parent 2

Home Telephone Number
	Parent 1	Parent 2

Email Address *Providing us with an email address will enable you to download our Arbor app, where you will be able to see your child's homework, attendance, timetable and reports. By providing us with an email address you will also be able to receive communications via ParentMail
	Parent 1	Parent 2

Other emergency contact details

Title
	Contact 1	Contact 2

Surname
	Contact 1	Contact 2

First Name
	Contact 1	Contact 2

Relationship to Student
	Contact 1	Contact 2

Mobile Number
	Contact 1	Contact 2

Home Telephone Number
	Contact 1	Contact 2

Lunch Arrangements

Select one of the three options* Please provide details of any food allergies/intolerances*

Medical Details

GP Surgery Name and Address* Any medical conditions (include any allergies/intolerances)* Medication needed during school hours: Please state name of medicine, dose and frequency.*

All medicines/medication supplied to us must be in the original packaging which indicates the expiry date and is clearly labelled with your child’s name, and you agree to us administering these medicines:*YesNo

You agree to us providing treatment in the case of emergency where considered necessary:YesNo

Special Educational Needs (SEN)

Does your child have any special needs provision?*YesNo

If yes, is your child on the SEN register at their current school?YesNo

Does your child have an EHCP?YesNo

Other Information:

Nationality* Home Language* Ethnicity*

Is a parent/carer a serving member of the armed forces?*YesNo

Whilst your child is at King's Lynn Academy, do you give permission for photographs and images to be used in the following places:*
	Yes	No
In King's Lynn Academy Publications
On the King's Lynn Academy website
By the local media

KLA uses biometric systems for catering and printing. The chosen method is thumbprint scanning. The process is completely safe and secure, your child will then be able to use cash loaders to top up their lunch accounts.*
	Yes	No
I am willing for my child to use the Academy recognition system

ICT/Internet policy - As a parent or legal carer of the above pupil, I grant permission for my son or daughter to use the internet at King's Lynn Academy. As a user, your child will agree to use the network in a responsible way and observe any restrictions. I understand that some materials on the internet may be objectionable and I accept responsibility for setting standards for my son or daughter to follow when selecting, sharing or exploring information and the media.*I agree

Sanctions - Your child will abide by the Academy's rules and sanctions, and you agree to them attending after school detentions.*I agree to same day after school detentionsI would prefer 24 hours notice

The 3 questions below are optional, and are collected only for school use to support multi-cultural activities and support student services. Providing this information is voluntary.

Has any member of your household received higher education e.g. university?YesNo

Is your child adopted?YesNo

Is your child a young carer?YesNo

Anything else you think we should know:

I certify that to the best of my knowledge, the information on this form is correct.*YesNo

Digital signature (please type your name)* Relationship to child:* Date*

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