Application Form

This form is to be completed by those with parental responsibility for the child.
Please complete where relevant, all sections in this form.

Child's details:

Surname:

Forename(s) (in full):

Known as:

Date of birth:

Gender:

Nationality:

Ethnicity:

Home Postcode:

Home Tel No:

Parent Mobile No:

Home Address:

Please state which and term you would like your child to start at Demetae Academy:

Current School:

Current Year Group:

Name:

Telephone No:

E-mail contact:

Name of Head Teacher:

Address:

Dates Attended:

Is your current school aware you are registering your child with Demetae Academy?

Do you have any fees arrears with your current school?

As part of the admissions process, we will contact your child's school for a confidential reference

Personal Information and Individual Needs:

Please outline your child's artistic, dramatic, musical or sporting skills, and their hobbies and interests:

Are there any circumstances relating to your child that we should be aware of?

Does your child have any medical conditions or disabilities?

Does your child have any special needs or learning difficulties?

Does your child have an Educational Psychologist report?

Does your child have any court orders or ongoing safeguarding concerns?

Parents Details:

Parent / Career 1

Title:

Surname:

First Names:

Address:

Postcode:

Occupation:

Nationality:

Home Phone:

Mobile Phone:

Work Phone:

Email:

Parent / Carer 2

Title:

Surname:

First Names:

Address:

Postcode:

Occupation:

Nationality:

Home Phone:

Mobile Phone:

Work Phone:

Email:

* If you have parental responsibility for the child in a capacity other than as a parent of the child, please state your relationship to the child here:

Please insert any further information in this space that you feel is relevant/ supports your child's application

Declaration:

We request the above named child be registered as a prospective pupil and we have made a payment of the non-refundable registration fee of £300. If Demetae Academy chooses to not offer a place this fee wil be refunded.

Payment to be made by bank transfer to

Account Name: Demetae Academy

Account Number: 13980467

Sort Code: 54-10-27

Please use your child’s initial and surname as a reference

By signing this registration form we understand, accept and agree