Enrolment Form 2020 Page 1 of 16

PRIVATE AND CONFIDENTIAL

STUDENT ENROLMENT FORM

Please fully complete each page of this form for your child. The information will be used for administrative

purposes within this school. It will be sent on to your child’s next school or other educational institution and also to

the Local Authority (LA) and School Health Nurse Service to enable them to maintain their records. Langtree School is entitled to collect this information under the provisions of the Data Protection Act 1998.

Please be aware that completion of this form does not guarantee a place for your child if this has not been notified in writing by Oxfordshire County Council.

SECTION 1: PUPIL’S DETAILS:

Legal Surname: Legal Forename:

Preferred Surname: Preferred Forename:

Middle Name: Any other names:

Gender: Date of Birth:

Student’s Mobile Number (for emergencies only):

This information will not be divulged to any person who is not a staff member.

Pupil Address Details:

Postcode: House Number/Name

Street:

Town/City: County:

Is this the pupil’s home address? YES / NO or term time only address? YES / NO

Additional Pupil Address:

Postcode: House Number/Name

Street:

Town/City: County:

If your child has siblings already at Langtree School please provide their name(s):

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SECTION 2: CONTACT DETAILS:

To fulfil the provisions of the Education (Pupil Registration) Regulations the school is required to keep an

admissions register that includes the name and address of every person considered, in law, to be the parent of a pupil. For the purposes of education law, the department considers a ‘parent’ to include:

• all biological parents, whether they are married or not

• any person who, although not a biological parent, has parental responsibility for a child or young person -

this could be an adoptive parent, a step-parent, guardian or other relative

• any person who, although not a biological parent and does not have parental responsibility, has care of a

child or young person A person typically has care of a child or young person if they are the person with whom the child lives, either full or

part time and who looks after the child, irrespective of what their biological or legal relationship is with the child.

If parents who do not live with the pupil wish to receive copies of school correspondence including

reports, please complete the “Second Parent” form in Pack 1.

Please list contacts in the order the school should make contact in the event of an emergency

Contact 1

Title: Mr / Mrs / Miss / Ms / Dr / Rev Other: Gender:

Surname: Forename:

Postcode: House Number/Name

Street:

Town/City: County:

Relationship to Pupil: e.g. Mother, Father etc.

Does this contact have Parental Responsibility? YES NO

Email address:

Home Telephone:

Mobile Telephone:

Work Telephone: Extension:

First Language of this contact:

Contact 2

Title: Mr / Mrs / Miss / Ms / Dr / Rev Other: Gender:

Surname: Forename:

Postcode: House Number/Name

Street:

Town/City: County:

Relationship to Pupil: e.g. Mother, Father etc.

Does this contact have Parental Responsibility? YES NO

Email address:

Home Telephone:

Mobile Telephone:

Work Telephone: Extension:

First Language of this contact:

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Contact 3

Title: Mr / Mrs / Miss / Ms / Dr / Rev Other: Gender:

Surname: Forename:

Postcode: House Number/Name

Street:

Town/City: County:

Relationship to Pupil: e.g. Mother, Father etc.

Does this contact have Parental Responsibility? YES NO

Email address:

Home Telephone:

Mobile Telephone:

Work Telephone: Extension:

First Language of this contact:

SECTION 3: NATIONALITY Please state the country of birth and nationality of your child.

Country of birth:

Nationality:

What is your child’s first language:

SECTION 4: ETHNIC MONITORING:

Please tick the ethnic group to which your child belongs. Please note that this question is not about citizenship or nationality. It is essential that we have this information so that we can monitor the effectiveness of the school’s and

the LA’s equal opportunities policies and practices in maximising your child’s progress and achievement.

White British should include any pupils from England, Scotland, Wales and Northern Ireland. White Irish should include any pupils from the republic of Ireland.

White British Asian or Asian British - Indian

White Irish Asian or Asian British - any other Asian background*

White Traveller of Irish heritage Asian or Asian-British- Pakistani

Any other white background* Black or Black-British - African

White Gypsy/ Roma Black or Black-British - Caribbean

Mixed – any other mixed background* Black or Black-British - any other black background*

Mixed - White and Asian Chinese

Mixed - White and Black African Any other ethnic group*

Mixed – White and Black Caribbean Prefer not to answer

Asian or Asian British -Bangladeshi *(please specify)

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SECTION 5: RELIGIOUS BACKGROUND:

Please tick your child’s religion (optional). Please tick one box only.

Christian Jewish

Muslim Buddhist

Hindu Other

Sikh No Religion

SECTION 6: ADDITIONAL INFORMATION:

Please indicate which type of meal your child will usually be taking at school:

Free School Meals Sandwiches

Paid School Meal Other

By law, children in families claiming one or more of the following benefits: Income Support / Employment Support

Allowance (IR) (ESA (IR)), Income Based Job Seekers Allowance, Support under the Immigration & Asylum Act 1999, Child Tax Credit provided that Working Tax Credit is not included and that the “annual income for Tax

Credit purposes”, is within the guidelines set for the financial year], the ‘Guarantee’ element of State Pension Credit are entitled to free school meals. Even if your child will not be taking free school meals it is important that

we have this information since it affects our funding and the way in which the school’s performance in tests and examinations is compared with that in other schools.

If your child currently has free school meals or you think your child may be eligible please complete the application for free school meals form at the end of this document (Appendix B)

Please indicate if your child is currently or ever has been in receipt of pupil premium funding.

YES NO

Please indicate if either parent are currently or have ever ever served in the military. Please state the date of end of service if applicable

YES (current)

NO YES (ended) DATE

Is this child an adopted child? YES NO

Is this child a looked after child? YES NO

Which local authority?

How will your child travel to school generally? Please tick one box only.

Walk Car

School Bus Public Transport

Bicycle Taxi

Other please specify:

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Please use the space below to provide any further relevant information about your child that you feel would help us to support your child at Langtree School, for example: has a learning disability, has missed education due to a significant medical reason, is a young carer.

Enrolment Form 2020 Page 6 of 16

SECTION 7: SCHOOL HISTORY: Please give details of all previous settings attended by your child. Please continue on a separate page if there is insufficient space.

School 1

Name of setting

Address

Starting Date: Leaving Date:

Reason for Leaving:

School 2

Name of setting

Address

Starting Date: Leaving Date:

Reason for Leaving:

School 3

Name of setting

Address

Starting Date: Leaving Date:

Reason for Leaving:

School 4

Name of setting

Address

Starting Date: Leaving Date:

Reason for Leaving:

School 5

Name of setting

Address

Starting Date: Leaving Date:

Reason for Leaving:

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SECTION 8: Permissions, parental consent

Student Name:

School Visits Permission for trips, visits and activities off site I am happy to give my advance permission for the above named student to participate in local trips, sports fixtures, visits and activities off site during the school day. These activities will include the Sponsored Walk, trips on Creativity Days and during Activities Weeks.as well as other occasional events. I understand that all such trips will be planned to meet the statutory requirements for health and safety, safeguarding and well-being of students, and that I will receive written notice of such events in advance of the date.

Signed: Date:

Name of Parent / Carer:

Student Name:

Use of Photography and Digital Media During your child’s time at Langtree School we often use digital media including photographs and film. Such media may be used in newsletters, on the school website and on occasion in the local press. These images are used to report and celebrate trips and activities at Langtree School. Your child may also be named in the caption to such images.

I give permission for my child’s image to be used as described above

Signed: Date:

Name of Parent / Carer:

I DO NOT give permission for my child’s image to be used as described above

Signed: Date:

Name of Parent / Carer:

Please note that these blanket permissions can be withdrawn at any time by writing to the Headteacher at the school address. Please include the student’s full name and your full name and relationship to the child in any correspondence relating to permissions.

SECTION 9: YOUR SIGNATURE: The information I have provided on this form is correct and I agree to inform the

school if there are any changes to the information provided.

Signature:

Name in BLOCK capitals please:

Relationship to child:

Date:

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SECTION 10: Home School Agreement and Code of Conduct

Langtree School Home-School Agreement

All schools have a Home-School Agreement. The purpose of this agreement is to set out, in broad terms, how students, parents and the school should work together to ensure that children achieve the highest levels of attainment possible. School students and parents are all asked to sign this document to demonstrate that they endorse the general principles that are set out within it and to show how we all work together for the educational benefit of your child. If you would like to discuss the agreement, please contact the head of year.

What does ‘Putting Learning First’ actually mean?

A real desire to put learning first at school and at home

An ambition to achieve your personal best

A commitment to our values of courtesy, tolerance and respect

A commitment to behave well so that others can learn and that teachers can teach

A desire to show pride in your work, yourself and your school

Student- I shall try to: • Aim for 100% attendance at school

• Attend every lesson on time expecting to work hard

• Always do my best in all areas of my school work, both in lessons and at home

• Follow the guidelines for Expectations for Learning

• Follow the Behaviour policy and uniform code

• Take advantage of all opportunities offered to me by the school both within and outside lessons

• Show respect for all members of the school and all property within the school

Parent/Carer- I /We shall try to: • Avoid any commitments which would impact on my child’s attendance at school

• Encourage my/our child’s regular, punctual attendance with proper equipment

• Encourage my/our child’s learning through homework and other activities

• Attend parent consultation evenings concerning my/our child’s progress

• Get to know and take interest in my/or child’s life at school

• Make the school aware of any concerns that might affect my/our child’s progress

• Support the schools behaviour policy and uniform code

Staff and Governors will: • Care for your child’s safety, well-being and happiness in a secure environment

• Create and maintain a purposeful environment for learning

• Plan lessons, including setting and marking of homework on a regular basis in line with school policy

• Implement consistent approaches for addressing behaviour issues

• Act as role models for in terms of modelling courtesy, tolerance and respect towards every body

• Contact you when we have a concern regarding attendance, attitude to learning or behaviour

• Encourage and motivate your child to do the very best they can

• Keep you informed about your child’s progress, homework and general school matters

In addition, we ask all parents to: • Telephone or email the school on the first day of any unexpected absence their child may have and

provide written explanation for a prolonged absence

• Support the school’s detention arrangements when required, and provide transport home if an after

school detention is set for their child

• Read all communications from the school, and respond to requests for returns in a timely manner

• Inform the school immediately if there is a change in contact details, mobile numbers or email

addresses

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Langtree Code of Conduct

At Langtree School, we aim to give students an excellent education in a caring environment, so that

each individual will feel able to take advantage of the many opportunities available.

Lifelong learning is central to the work of Langtree School. Our aim is to help our students develop their

talents and be acceptable in order to assume a positive role in society.

At Langtree School we expect everyone to act with courtesy and consideration

This is reflected in:

• The way we speak to other people

• The way we listen to others and value their opinions, even if they differ from our own.

• The way we help and encourage others.

At Langtree School we expect everyone to be punctual

This means we will:

• Arrive in school on time

• Arrive in lessons on time and with the correct equipment

• Ensure that homework, coursework and other assignments are completed on time.

At Langtree School we expect all students to take pride in their appearance and to respect

their own and other people’s belongings

This means we will:

• Wear correct uniform

• Treat other people’s property as we would expect others to treat ours.

At Langtree School we expect everyone to move around the school sensibly

This means we will:

• Walk round the corridors and not run

• Behave sensibly on stairs, in cloakroom areas and in crowded doorways, paying attention to the

safety of others at all times

• Be prepared to open doors and assist others when they need it.

At Langtree School we care about the environment both globally and locally

This means we will:

• Put all litter in the bins provided inside and outside school

• Keep all walls, furniture, books and equipment clean and unmarked.

• Ensure that all displays remain in good condition for other people to enjoy.

At Langtree School we expect all students to come to school safely and represent the school

in the wider community.

This means we will:

• Behave sensibly at bus stops and on the bus.

• Wear correct uniform and follow the school rules on the way to school

• Be polite and courteous to members of the community

Enrolment Form 2020 Page 10 of 16

Langtree School Home School Agreement & Code of Conduct

(Please sign below to acknowledge that you have read and agree to both documents)

Name of student:

I agree to follow the school code of conduct, the code of contact for the use of the internet & Home School Agreement. Signature of student:

Name of parent / carer:

I agree to encourage my/our child to observe the conditions of the Home school agreement & The School Code of conduct. Signature of parent / carer:

Date:

On behalf of the school and governors:

Electronic copies of the School Policies can be found on the school website www.langtreeschool.com/school-policies Printed copies can be requested from the school office, please email office@langtreeschool.com.

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SECTION 11: Health

School Health Nurse Langtree School

Reading Road Woodcote

Reading RG8 0RA

01491 680514

Secondary School Entry Health Review

Dear Parent or Carer, As your son or daughter is now entering a new school we would like to take this opportunity to introduce the school & college health nursing service in secondary schools and colleges in Oxfordshire. The service is commissioned by Public Health, Oxfordshire County Council and provided by Oxford Health NHS Foundation Trust. School Health Nurses are based in schools and colleges, and work in partnership with teaching and pastoral school staff to provide support and guidance to students, to help them make healthy lifestyle choices. School Health Nurses School Health Nurses have undertaken specialist training to care for young people in a school setting and deliver the best evidence based practice, to help young people make healthy choices and keep them safe. School health nurses have full access to support services and adhere to the professional standards outlined in the Nursing, Midwifery Council (NMC) Code of Conduct; further information is available at www.nmc.org.uk Medical Conditions and completing the questionnaire It is important that schools are aware of any medical conditions your child may have prior to starting school, this includes conditions that may be under control and managed purely at home. Please complete the attached form and return it to your child’s new school, this will enable school staff and the school health nurse identify young people with health needs. (Appendix A) Medicines in schools If your child needs medication to be available in school, for example, adrenaline (Epipen) for a severe allergy or an inhaler for asthma, it is important to know that schools have their own procedures for administering medicines. If your child needs to take medication during the school day, you will need to discuss this with your child’s school, the student support officers will be able to help. As part of this procedure, you may be asked to complete a consent form giving permission for school staff to administer medicines to your child. All medications taken into school must have a pharmacy label with the name of your child, the medicine with the dose and times the medicine is required. It is the parent’s responsibility to ensure any medication given to school is in date and that it is replaced before it has expired. Health review During the Autumn Term there will be an opportunity for the school health nurse to offer your child a health review if required. Parents/carers are not routinely asked to attend for the health review; however you may of course attend if you wish. If in the future you identify a health concern please contact the school health nurse, details above. The school staff or school health nurse will also contact you if they are concerned about the health of your child. The school health nurse offers a weekly ‘drop in’ session in school usually over lunchtime for students, so if they have a health concern they are able to ‘drop in’ and see the school health nurse.

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Confidentiality, safe-guarding and record keeping The service provided by the school health nurse is independent from the school, and school health nurses can offer a confidential service to students. If there are concerns that the child or other young people are at risk of harm this information will be shared to ensure the safety of the child. School health nurses maintain confidential health records on all children and young people using the services of Oxford Health NHS Foundation Trust. These health records will be held securely and strictly in accordance with Caldicott Guidance. Further information can be found at: http://systems.hscic.gov.uk/infogov/igfaqs/quickreferencef.doc Secondary School Health Review Questionnaire We look forward to working with you during your son or daughter’s time at school or college; please do not hesitate to contact us for further information. Please keep this part of the letter and return your Secondary School Entry Health Review Questionnaire to your child’s new school. Yours sincerely The School Health Nurse

Useful Health Information Free Eye Tests Eye tests for children are essential health checks and are free for every child under 16 and every young person under 19 if they are in full-time education. They are easy to arrange by phoning your local optician to book an appointment. NHS Dentists For help with finding an NHS dentist please phone the Oxford Health Dental Helpline on: 08000 113 824 or 01865 337 267. For general enquiries email: dental@oxfordhealth.nhs.uk Does your child live in a smoke-free home? Free friendly support to quit smoking is available from Quit4Life on 0845 602 4663 or visit http://www.quit4life.nhs.uk/ Healthy Lifestyle Join Change 4 Life for free easy tips on maintaining a healthy lifestyle for all the family https://registration.change4life.co.uk/ NHS Choices This is the recommended website for all health queries, as this is maintained by the NHS and will be up to date and evidence-based. http://www.nhs.uk/pages/home.aspx Your child at school Very useful information on topics relating to life in school. http://www.nhs.uk/livewell/yourchildatschool/Pages/Yourchildatschoolhome.aspx NHS Behind the Headlines This website is particularly useful if you would like to find out more information on a current news story on a health topic. http://www.nhs.uk/news/Pages/NewsIndex.aspx School Health Nurses Website More information regarding the role of the school or college health nurse can be found on the following website http://www.oxfordhealth.nhs.uk/children-and-young-people/oxon/school-health-nursing/

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Appendix A Secondary School Entry Health Review Questionnaire Please complete and return the questionnaire to your child’s secondary school. This information will be shared with designated school staff and treated in strict confidence.

Secondary School

Child's Surname

Child's First Name Date of Birth

Gender

Parent/carer’s names

Home Address

Contact telephone numbers

Email

GP Name and Address

NHS Number (if known)

Medical Conditions Please indicate below if your child has any of the following medical conditions or difficulties. If your answer is YES, please give details of any medication required, which health professionals help manage your child’s condition e.g. Hospital team, GP or other service. Please provide details if their condition may affect their participation in school activities, e.g. Sports and swimming.

Condition YES or NO

Please give details -medications required/ managed by hospital or GP/if this may affect school activities

Asthma

Diabetes

Epilepsy

Serious allergies

Does this require Adrenaline in school (Epipen/Jext?)

Skin condition

Bladder or bowel problems

Mobility

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Condition YES or NO

Please give details -medications required/ managed by hospital or GP/if this may affect school activities

Sensory or attention deficient disorders (ADHD)

Hearing

Speech

Vision

● Wears glasses in general

● Glasses for reading

Other medical conditions

Will you son/daughter need medication during school hours? YES / NO

If YES please give details:

If you would you like the opportunity to discuss your son/daughter’s health review with the school health nurse please contact her at the number above within the first term of your child starting school.

Thank you for completing this form.

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APPENDIX B

Dear Parent/Guardian APPLICATION FOR FREE SCHOOL MEALS We would like to make you aware of the ‘Free School Meals’ scheme which operates in our School. Pupils whose parents/guardians are in receipt of particular support payments and meet certain criteria may be eligible to receive free school meals. The relevant support payments include:

Income Support (IS) or Employment Support Allowance (IR) (ESA (IR)) – proof of entitlement is in the form of a Job Centre plus letter or FF260 form or letter from the Department of Work & Pensions. ESA (C) is not eligible

Income Based Jobseekers Allowance (IBJSA) – proof of entitlement is in the form of a Job Centre plus letter.

Support under part VI of the Immigration and Asylum Act 1999 – proof of entitlement is in the form of a Home Office letter.

Child Tax Credit, provided that Working Tax Credit is not included, and that your ‘annual income for Tax Credit purposes’ does not exceed a threshold figure. – proof of entitlement is assessed by the ‘TC602 Award Notice’

The Guarantee element of State Pension Credit will be an additional qualifying ‘benefit’ – proof of entitlement is assessed by the ‘Pension Credit M1000 Award Notice’.

Should you feel you might qualify, please complete the application form and return this to Langtree School. We will verify the entitlement through “The Hub” at Oxfordshire County Council.

Should you be entitled to the free school meals scheme you should be aware that you have a legal duty to inform your school of any changes to your support payment. Re-application to the scheme will be required on a six monthly basis.

Yours sincerely Mrs A Temple Pupil Premium Lead Langtree School

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APPENDIX B

APPLICATION FOR FREE SCHOOL MEALS Please complete and return to your School together with an original proof of the relevant support payment(s) (your proof must be the official documentation that is sent from the Agency). The relevant support payments are:- (1) Income Support/Employment Support Allowance (IR) (ESA(IR)) (2) Income Based Job Seekers Allowance (3) Support under the Immigration & Asylum Act 1999 (4) Child Tax Credit [(1) provided that Working Tax Credit is not included (2) and that the “annual income for Tax Credit purposes”, is within the guidelines set for the financial year] (5) The ‘Guarantee’ element of State Pension Credit (6) Universal Credit

Parent/Guardian details:

Surname Title First Names

Address & Postcode

Date of Birth:

Please give details of each child, including the school they attend: Full Name Date of Birth Address Name of School

Which benefit are you in receipt of: √ Dated from Dated to NI/Reference No.

Income Support/ESA (IR)

Job Seekers

Immigration & Asylum Act

Child Tax Credit with “the annual income for tax credit purposes” is within this year’s threshold figure (No Working Tax Credit - if unsure pass to School for assessment)

‘Guarantee’ element of State Pension Credit

Universal Credit

I declare that the particulars stated on this form are correct and that I am in receipt of one of the relevant support payments for free school lunches. I agree that you will use the information I have provided to process my claim for free school lunches and will contact other sources as allowed by law to verify my initial, and ongoing, entitlement I undertake to notify the school immediately I cease to receive or have any changes to the relevant support payment (please note that you will be required to meet the cost of any free meals provided after the date you cease to receive entitlement).

Signature………………………………. Date………………….

FOR OFFICE USE ONLY I have checked the free school meal hub/I have viewed the original Award Notice/Letter –

Name………………………..………………………Date…………..……………

………….number of children entitled to free school meals. Period of entitlement: from……….……..to…………….…….

Appendix B 2010 /2011