Confirmation of Leaver Form

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Form to be completed by the parent/carer when advising that their child will be leaving Dundonald Primary School.

It is a legal requirement for schools to collect this information, please provide as much detail as possible. If the new home address is unknown, please supply details of a temporary address (e.g. hotel, business or relative) where you will be staying initially.

Email *

Child's surname: *

Child's forename: *

Date of Birth: *

YYYY

Year Group: *

Nursery

Reception

Year 1

Year 2

Year 3

Year 4

Year 5

Year 6

Required

Last day at Dundonald: *

YYYY

Reason for leaving: *

Details of new home address: *

If moving abroad, date of flight: (if not moving please put 01/01/0001) *

YYYY

Full name and address of new school: *

New school telephone number: *

New school email: *

Expected start date at new school: *

YYYY

Parent/Carer's name: *

Is your child entitled to Pupil Premium *

Yes

Consent of parent: *

I declare that all this information is true and accurate to my knowledge

Required

A copy of your responses will be emailed to the address you provided.

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