Data collection - student information
Please complete all details into the form below where possible. It is very important that we have up-to-date information. We regularly send communication via text or email, so please ensure these are given and advise us if these change.
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Email *
Please state your child's legal forename *
Please state your child's middle name. Please enter N/A if none *
Please state your child's legal surname *
Please state your child's preferred forename *
Please state your child's preferred surname *
Please tick which applies to your child. *
Required
Please enter your child's mobile number. Please enter N/A or 0 if none *
What is your Child Tutor group? *
Please state your child's home address *
Contact 1- State your name *
Contact 1- What is your relationship to the student? *
Contact 1- Do you have Legal parental responsibility for this child? *
Contact 1- What is your home address? *
Contact 1- What is your mobile number? *
Contact 1- What is your home number? Please enter N/A or 0 if none *
Contact 1- What is your place of work and work contact number. Please enter N/A or 0 if none *
Contact 1- What is your email address? Please enter N/A if none *
What is the name of contact 2? Please enter N/A if none *
Contact 2- What is your relationship to the student? Please select N/A in none *
Contact 2- Do you have Legal parental responsibility for this child? *
Contact 2- Home address. Please enter N/A if non *
Contact 2-  Mobile number. Please enter N/A or 0if none *
Contact 2- Home number. Please enter N/A or 0 if none *
Contact 2- Place of work and work contact number. Please enter N/A or 0 if none *
Contact 2- Email address. Please enter N/A if none *
What is the name of Contact 3?
Contact 3- What is your relationship to the student?
Contact 3-Do you have Legal parental responsibility for this child?
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Contact 3- Home address.
Contact 3- Mobile number.
Contact 3- Home number. Please enter N/A or 0 if none
Contact 3- Place of work and work contact number. Please enter N/A or 0 if none
Contact 3- Email address. Please enter N/A if none
Name of your child's Medical practice *
Any medical conditions your child has. Please enter N/A if none *
Any medical notes regarding your child. Please enter N/A if none *
What is your child's Ethnicity? *
What is your child's country of birth? *
What is your child's nationality? *
What is your child's Religion? Please enter N/A if none *
What is your home language? *
Who was this form completed by? *
Date *
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