Bassaleg School Admission Form

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PUPIL'S PERSONAL INFORMATION

This section is to be completed by the Parent or Guardian. Please enter the pupil's full name, AS IT APPEARS ON HIS /HER BIRTH CERTIFICATE - this is vital for all official documents such as examination entries and certificates.

Pupil's Legal Surname *

Pupil's Legal Forename *

Pupil's Preferred Surname *

Pupil's Preferred Forename *

Pupil's Date of Birth *

YYYY

Pupil's Sex *

Male

Female

Pupil's Full Home Address (inc Postcode) *

Pupil's Home Telephone Number *

Name of Pupil's Doctor *

Year of Admission to Bassaleg *

Name & Address of Doctor's Surgery *

Telephone Number of Doctor's Surgery *

Does the Pupil have any medical conditions that the school should be aware of? *

Yes

Please provide brief details below. For more detailed information, please make sure you complete the Pupil Medical Information Google Form, which is accessed by our School Medical Officer.

Please list the Pupil's previous school(s) *

Please provide the name and current year for all brothers and sisters currently at Secondary School *

Pupil's place in the family (for example first child of three etc) *

Does the Pupil have identified additional educational needs? (also know as special educational needs) *

Yes

Was the pupil born in the UK? *

Yes

If the pupil was NOT born in the UK, please indicate their country of birth.

If the pupil was NOT born in the UK, please indicate their date of entry into the UK.

YYYY

If the pupil was NOT born in the UK, please indicate their country/countries of previous education

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