* Required Field 1. Student's Details
Student's Family Name / Surname(s)*
Student's Given Name/ First Name(s)*
Student's Date of Birth*
Student's Home Address*
Students Current School Year*
Please Select
Year 7
Year 8
Year 9
Year 10
Year 11
Does the Student have a sibling(s) living at the same address attending any PolyMAT Academy?*
If Yes, please provide name(s), school(s) and Date(s) of Birth(s) of Sibling(s) who already attend any PolyMAT Academy
Is the Student's parent/carer a member of staff at any PolyMAT academy?*
If Yes, please provide the name of the school and staff member name
2. Details of Current/Previous School
Full name of Student's current school/last school attended and full address (including postcode)*
Last date of attendance*
Reason for leaving current school*
Has the Student previously been educated abroad?
If Yes, please provide the name and full address of the school (including country)
Start Date
End Date
Date Returned to the UK
Have you notified the Students current school of your application *
3. Parent or Carers details
Primary Contact
Title*
Please Select
Mr
Miss
Mrs
Ms
Rev
Dr
Other
Family Name/ Surname*
Given Name/ First Name*
Parent/Carer home address (including postcode)*
Daytime Telephone Number*
Email Address*
Relationship to Student*
Secondary Contact Details
Title*
Please Select
Mr
Miss
Mrs
Ms
Rev
Dr
Other
Family Name/Surname*
Given Name/ First Name*
Address*
Relationship to Student*
Day time contact number*
Third Contact
Title*
Please Select
Mr
Miss
Mrs
Ms
Rev
Dr
Other
Given Name/ First Name*
Family Name/Surname*
Relationship to Student*
Day time contact number*
4. Looked After Children
Is the Student adopted?*
Is the Student a child looked after or previously looked after and now adopted or subject to a residence or special guardianship order immediately following having been looked after?*
If Yes, please provide the date the student went into care
Borough of Care for looked after child
Does the Student have a Private Guardianship*
Is the Student a young carer*
5. SEN, Medical or Social
Does the student have a current EHCP?*
Does the Student have any Special Educational Needs (SEN)?*
If Yes, please provide more information
Do you feel that there is an acute exceptional medical or social reason why your child should be offered a particular school?*
6. Ethnic/Cultural Background
Student's Ethnicity*
Please Select
Bangladeshi
Black - African
Black Caribbean
Chinese
Gypsy/Roma
Indian
Pakistani
Traveller of Irish Heritage
White - British
White - Irish
White and Asian
White and Black African
White and Black Caribbean
Any other Asian background
Any other Black background
Other ethnic group
Any other mixed background
Any other White background
Prefer not to say
Is the Student identified as EAL (English as an Alternative Language)*
If Yes, how would you categorise their level
Student's country of Birth*
If outside of the UK please provide Date of Arrival in UK
Students who are given a place at Woolwich Polytechnic School will be invited in for an interview and test, would you require an interpreter?*
If Yes, please specify for what language
7. Additional Information
Has the student been permanently excluded? *
Is the student currently being educated at home*
Are any of the Students Guardians in the Armed Forces?*
You have no recourse to Public Funds*
Title
Verification*Slide the arrow to the right to complete verification.
