Gateshead Common Application Form
In Year School Transfer Request
Please ensure that you have fully completed all sections of the form as any missing information may delay your request
Details about your child:
Surname:
Boy/Girl:
First Name(s):
Any other Surnames used:
Date of Birth:
Year Group:
First Language of Child:
Does your child speak English? Yes
No
Current Address:
New Address if applicable and Moving Date:
Are you new to the UK:
Yes
No
Nationality
Details about you:
Mr / Mrs / Miss / Ms
Full Name:
Your relationship to the child:
Do all those with parental responsibility for the child agree to this request? Yes
Year
Group
Contact
Tel No*
No
Mobile
E-mail Address
* It is important that a day time contact number is provided.
Information about your child:
Is the child:
In Public Care
An Asylum Seeker
UK Armed Forces Family
A Traveller Child
A Refugee
A Carer *
Permanently Excluded
Private Fostering Arrangement
None of these
* Does your child help care for a family member in the home?
Current School:
Please fill in the details of your child’s current school or the school that they last attended:
School Name
Address
Town/County
Name of Headteacher:
Tel Number
Date child started:
Date child last attended:
Other Schools attended
Please list any other schools that your child has attended in the last 3 years:
School Name:
Town:
Attended from:
To:
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Reason for leaving:
Name
Headteacher:
Schoolof
Name:
Town:
Attended from:
To:
Reason for leaving:
Name of Headteacher:
School Choices:
Please list which schools you would like to apply for in order of preference:
1.
2.
3.
Headteacher:
When Name
is the of
place
at the above school(s) needed from?
Please give details of any siblings who are already attending or will be attending this school:
Surname
Forenames
Date of Birth
Gender
Address (if different to child
applying
If you name a Religious School as one of your preferences: You must answer the following:
Is your child a baptised Catholic: Yes
No
Is your child a member of a Christian Church: Yes
(NB the school may require proof of baptism)
No
If so please state which:
If your child belongs to a faith other than Christian please state which:
Further
details about the transfer:
Name of Headteacher:
If you are applying for a transfer from another Gateshead school because your child is having
problems with the current school:
Have you meet with your child’s Head Teacher, Class Teacher or Head of Year? Yes
Person’s Name:
No
Date:
Issues raised:
Have you met with the following to help you? Please tick and give details:
Family Intervention Team
Parent Partnership
Education Welfare Officer
Behaviour Support Service
Social Services
Youth Offending Team
Additional information:
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Chair of Governors
Other(please state)
Special Education Needs
Does your child have Statement of Special Education Needs? Yes
No
If the answer is YES, please contact Pupil & Parent Services as there is a separate transfer process.
Tel: 0191 4333641
Is your child receiving support at either School Action or School Action Plus? Yes
No
Reason for transfer
Please provide a reason for your request (we are unable to process your request without this information)
PLEASE NOTE THAT YOUR CHILD MUST CONTINUE TO ATTEND THEIR CURRENT
SCHOOL UNTIL THE TRANSFER PROCESS IS COMPLETE
Declaration
I certify that the information, I have given, is correct. I also give permission for you to contact any
relevant agencies to confirm that the information specified on this form is correct. I consent to Gateshead
Council processing the information detailed in this form. I understand that this will be used by the local
authority for its administration purposes and my consent is based upon Gateshead Council complying with
the Data Protection Act 1998.
Name:
Date:
Signature:
Please return completed forms to:
Behaviour & Attendance Team,
Dryden Centre,
Evistones Road,
Low Fell,
Gateshead,
NE9 5UR
Applications will be processed no more than six weeks in advance of a school place being required.
PLEASE NOTE: It is parent’s responsibility to ensure that the Local Authority receives
your completed application form. Receipt of your application form will not be
acknowledged, however you may like to call the Education Support Team on 0191
4338589, who will be able to check if your application has been received.
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