Beech Hall School Application Form  
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Email *
Child's surname *
Child's first name(s) *
Child's Preferred Name *
Please indicate the name your child would like to be known by
Child's date of birth *
Gender *
Child's Address (inc. postcode) *
Year Group on Entry
 *
Proposed Date of Entry
 *
Contact Details - Parent/Carer 1
Name *
Address (if different from child's)
Phone number (mobile) *
Additional phone numbers
Please indicate home or work
Preferred Email Address *
Parent/Carer 1 Occupation *
Relationship to child *
Parent/Carer 2 - Name (inc. title)
Parent/Carer 2 - Address
If different from child's 
Parent/Carer 2 - Phone number (mobile)
Parent/Carer 2 - Additional Phone number
Please indicate home or work
Parent/Carer 2 - Email address
Parent/Carer 2 Occupation
Parent/Carer 2 - Relationship to child
Current School (inc. address) *
Date started at current School *
Name of Headteacher *
Local Education Authority *
Previous schools & dates attended
If applicable

SEND

 *
If your child experiences any barriers to their learning or has an identified Special Education Need or Disability (SEND) please provide details. Please indicate if not applicable
Does your child have an EHCP in place? *

If your child is 'cared for', been previously 'cared for' by a Local Authority or adopted please provide details

Medical/Dietary Information *

If your child has a medical condition, including allergies please provide details. Please indicate if not applicable.

Pastoral Information *
Please provide any further information that you would like us to be aware of, or might be useful to the Form Teacher to help your child settle in
Language *
My child's first language is....
Hobbies & Interests *

Name of person submitting the form

 *
Many thanks for your responses. Please now press submit
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