Kantor King Solomon High School

Data Admission Form

Mid Term Admission 2020

For office use

Student name:

Year group: Reg group:

Start date: Entered on SIMS:

Subject options:

Please complete this form in black ink (remember to print in BLOCK CAPITALS throughout). This information will allow us to handle administration more efficiently and will enable us to contact you in an emergency. All data will be stored and used in line with the Data Protection Act.

Student’s personal information

Legal Forename

Legal

surname

Middle names

Preferred forename

if different

Preferred surname

if different

Date of birth D D M M Y Y Y Y Gender M / F

Student Home

Address

Include postcode

Student home

telephone

Student mobile

phone number

Previous school

attended Previous school if in the UK or previous country if student didn’t attended a previous UK school

Previous school

address

Was the student previously in receipt of free school meals? Yes No

Was the student previously in receipt of Special Educational Need provision? Yes No

Does the student have an EHCP? Yes No

Please gives details of any previous SEN provision

First parental contact (living at student’s address)

First parental contact will be primary contact for text & email notifications & alerts and access to student reports

Title Mr/Mrs/Miss/Dr Forename

Surname Relationship Mother/Father/other family/carer

Available in emergency to collect student from school? Yes No

Please provide all

numbers we can

contact you on

Email address

Second parental contact

Title Mr/Mrs/Miss/Dr Forename

Surname

Relationship to

student Mother/Father/other family/carer

Available in emergency to collect student from school? Yes No

Please provide all

numbers we can

contact you on

Address if different

to student’s Include postcode

Email address

Does student live with Both parents: Mother: Father: Other:

Are parents separated? Yes No Are parents divorced? Yes No

If ‘Yes’ please indicate which parent has legal custody:

Is a parent prevented from having access to the student as a result of a court order? Yes No If yes, please provide a copy of the court order. Any additional details may be given below including parent’s name.

Is the above named child adopted? Yes No

Mobile:

Home:

Work:

Mobile:

Home:

Work:

Parent’s name prevented from having access to student

If other, please specify

First Additional emergency contact

Title Mr/Mrs/Miss/Dr Forename

Surname

Relationship to

student Other family member/Child minder/Other

Available in emergency to collect student from school? Yes No

Please provide all

numbers we can

contact you on

Address

Include postcode

Email address

Second Additional emergency contact

Title Mr/Mrs/Miss/Dr Forename

Surname

Relationship to

student Other family member/Child minder/Other

Available in emergency to collect student from school? Yes No

Please provide all

numbers we can

contact you on

Address

Include postcode

Email address

Mobile:

Home:

Work:

Mobile:

Home:

Work:

Medical information

Dietary needs:

Artificial colouring allergy Gluten free Halal

Kosher foods only No dairy produce No nuts

Seafood allergy Vegetarian

Other/additional dietary needs:

Is the student already receiving paramedical support?

Occupational therapy Physiotherapy Speech Therapy

Medical practice

student is registered

to:

Address

Include postcode

Medical conditions:

Epilepsy Diabetes Asthma

Eczema Arthritis Multiple sclerosis

Other/additional medical conditions:

Is your child on any regular medication?:

Does the student require an Epipen? Yes No

If yes, please ensure he/she has one to carry at all times, and a second to be stored at Reception.

Please give details of any previous or current significant medical conditions?:

If the student suffers from Asthma or Anaphylactic reactions, please bring a spare, named inhaler or Epipen to the

Medial Room on the first day of term. It is a parental responsibility to replace out of date inhalers/Epipens.

Ethnic and cultural information

At the point of admission, we collect ethnic and cultural information that can assist us with funding and recognise the diversity

of our school and allow us to identify student’s needs such as languages that the students are exposed too either during early

development or still exposed to that may require additional support.

In addition, throughout the year we gather data on pupils, which is used by the school and education services for a variety of

reasons. This year some additional data was included at the request of the Department of Education (DfE) which gathered

information on ethnicity, nationality, country of birth and proficiency in English. Parents have both the right to refuse to provide

this data and have the right to request that this data is retracted at any time.

Although the data is part of a wider data collection exercise carried out by the DfE (which is used to help determine school

funding among other things), we are advised that the data is not been passed onto the Home Office and will not be passed to

the Home Office at any point in the future.

Ethnicity

White – British White – Irish White European White and Black African White and Asian White and Black Caribbean White Other Black – Angolan Black – Congolese Black – Ghanaian Black – Nigerian Black – Somali Black Caribbean Any other Black background Other Black African Asian and Black Bangladeshi Indian Mirpuri Pakistani Kashmiri Pakistani Other Pakistani Sri Lankan Sinhalese Sri Lankan Tamil Sri Lankan Other Chinese Other Asian Greek/Greek Cypriot Turkish/Turkish Cypriot Kosovan Gypsy Gypsy/Roma Gypsy/Roma Traveller of Irish heritage Roma Other mixed background Any other ethnic group

Student’s first language

Student’s Home language

Does the student communicate with any members of the family in a language other than English? Yes No

Country of birth

National identity:

British English Irish Scottish Welsh Other

Religion:

Buddhist Christian Hindu Jewish Muslim

Sikh No Religion Other Religion

e.g. United Kingdom

Use of photographic and video images

Sometimes we may take photographs or video images of the students at our school. We may want to use these in our school prospectus or other printed publications, as well as on our website or on project display boards at our school. We may also make video recordings for educational use.

From time to time, our school may be visited by the media, education researchers, education providers etc. who will take photographs or video images of a visiting dignitary, high profile events, students working on a particular aspect of the curriculum and so on. Students will often appear in these images, which may appear in local or national newspapers, on television or published in text books, research papers and education journals. It is also the case that these images will appear on the websites of these organisations as well.

By signing this section, I consent to photographs and digital images of the student named in this form being used by the school as outlined above.

Your name: Your relationship to the student:

Signature: Date:

Youth Support Service Agreement

If your child is aged 12 or over, we also have to pass information to the Youth Support Services, run by the Redbridge local authority, who provide advice, guidance and access to personal development opportunities to all young people aged 13 -19. This information includes names and addresses of the child, the date of birth and their parents’ names. As a parent or guardian, you can choose not to allow the school to disclose any further information about your child to the Youth Support Service other than your child's name and address. If your child is aged 16 or over, your child has the right to decide whether information is passed onto Youth Support Service. Please tick here if you wish to opt-out of this arrangement Please tick here if you wish to stay in this arrangement

Please see our Privacy Notice on the school website which explains how we deal with your child’s information and

the rights you and your child have.

Thank you for completing these details. Finally, please ensure you have completed all sections of this booklet (including the Home-School Agreement and Parental Voluntary Contribution Information Form at the back).

Please also enclose a copy of the student’s passport or birth certificate.

Declaration

Data Protection Act 1998: the school is registered under the Data Protection Act for holding personal data. The school has a duty to protect this information and to keep it up to date. The school is required to share some of the data with the Local Authority and with the DCSF.

I declare that all the particulars and information and details given/filled in this application form are true, correct, complete and up-to-date:

Your name: Your relationship to the student:

Signature: Date:

Mother/Father/carer

Mother/Father/carer

CONSENT

Kantor King Solomon High School School Motto

HOME SCHOOL AGREEMENT

Kantor King Solomon High School believes that a truly effective education requires school, parents and students to

work together. This partnership agreement is to help make clear what you can expect from the school; and what the

school expects from parents and students;

We aim to provide you with

A high quality education, based on traditional Jewish values

A safe, caring and well-ordered environment

A school that treats each student as an individual

A community that expects mutual respect for all its members

A system of rewards and sanctions that are designed to be firm, fair and just.

High expectations for all students

Systems that monitor and assess progress and achievement

Clearly defined channels of communication

A range of extra-curricular activities designed to enrich the educational experience.

In turn, we expect that students and parents will

Support the Jewish ethos of the school

Share our commitment to high achievement for all

Support the staff in enforcing school rules and codes of behaviour and uniform

Approach all teaching and non-teaching staff with courtesy and respect

Be positive and take pride in Kantor King Solomon High School

Enter fully into the life of the school

‘If I am not for myself, who will be

for me?

If I am only for myself, what am I?

If not now, when?’

Ethics of the Fathers 1:14

In particular, we ask STUDENTS to follow the school rules and to remember to

Give of your best at all times

Attend school in full uniform and with everything you need for lessons

Be polite and respectful to all adults in the school

Respect your fellow students

Ask if there is anything you do not understand

Look after the school environment

Behave on your journeys to and from school in a sensible manner

Give priority to any school event you are involved in.

Come to school on time every day –remember, you are not allowed to go on holiday during term time. Finally, remember that people will always identify you as a King Solomon student, particularly where you are in a crowd of friends from school. We always want to be proud of the way you behave just as we hope you will always be proud to be part of the school. In addition to the general principles above, we expect that PARENTS/CARERS will

Keep the school fully informed as early as possible of anything which may affect your son/daughter

Respect the school's procedures regarding appointments

Support the school’s disciplinary procedures

Adhere to the school’s attendance policy (found on the school website). This means that you will

i. Ensure your child attends school regularly ii. Notify the school office of the reasons for any absences initially through the absence line and then by

written notification. iii. Not take your child out of school for holidays during term time. iv. Make any requests for time off during school to the Head teacher in good time prior to the event. v. Make every attempt to schedule medical appointments after school hours or in holiday time.

Attend all meetings concerning the progress of your child

Respond to Governors' information about Parental Contributions

Be sensitive to the Jewish ethos of the school and the backgrounds of our students.

We look forward to working in partnership with you to provide the highest quality of education and care for your child.

We understand and support this Home – School Agreement. Signed:

For the school Date

Parents/Guardians Date

Name of Student Date

ICT Acceptable Use Policy (AUP) Form

STUDENT VERSION

School computer and Internet use must be appropriate to the student's education.

Access must only be made via the user’s authorised account and password, which must not be given to any

other person.

Personal storage media (USB drives, CDs, Online Storage Clouds etc...) must not be brought into, nor access in

school unless permission has been given.

Copyright and intellectual property rights must be respected.

Users must respect the work of others which might be stored in common shared areas on the system.

Conversely, users should always try and store their files and data in their own secure area. Files and data

stored in common shared areas of the system must be transferred at the earliest opportunity to the users own

area. Such files will be regularly removed from the system.

Users are responsible for e-mail they send and for contacts made. E-mail should be written carefully and

politely. As messages may be forwarded, e-mail is best regarded as public property. Anonymous messages and

chain letters must not be sent.

Users should report any unpleasant material or messages received to a member of teaching staff. The report

will be confidential and will help protect others.

The use of public chat rooms or instant messaging is not allowed.

The school ICT systems may not be used for private business purposes, unless the Headteacher has given

permission for that use. Use for personal financial gain, gambling, political purposes or advertising is

forbidden.

The security of ICT systems must not be compromised, whoever they belong to.

Irresponsible use may result in the loss of Internet access or even an account suspension. Kantor King Solomon

High School may exercise its right by electronic means to monitor the use of the school’s computer systems,

including the monitoring of web-sites, the interception of E-mails and the deletion of inappropriate materials

in circumstances where it believes unauthorised use of the school’s computer system is or may be taking place,

or the system is or may be being used for criminal purposes or for storing text or imagery which is unauthorised

or unlawful.

I understand and will abide by the provisions and conditions of this agreement. I understand that any violations of the

above provisions may result in disciplinary action and the removal of my privileges. I also agree to report any misuse

of the system to a staff member. Misuse may come in many forms but may be viewed as any messages sent or received

that indicate or suggest pornography, unethical or illegal activities, racism, sexism, inappropriate language, any act

likely to cause offence or other issues described above.

Student Name: _________________________________________________

Form:_________________________________________________________

Signature:_____________________________________________________

ICT Acceptable Use Policy (AUP) Form

PARENT or CARER VERSION

Kantor King Solomon High School students must also have the signature of a parent or carer who has read this

agreement.

As the parent or Carer, I have read this agreement and understand that access to electronic information services is

designed for educational purposes. I understand that, whilst the Internet Service Provider operates a filtered service,

it is impossible for Kantor King Solomon High School to restrict access to all controversial materials and will not hold

the KKS responsible for materials acquired on the network. I also agree to report any misuse of the system to KKS.

I hereby give my permission to Kantor King Solomon High School to permit my child access to electronic information

services and I certify that the information given on this form is correct.

Parent or Carer Name:_________________________________________________

Signature:___________________________________________________________

Date: ______________________________________________________________

PARENTAL VOLUNTARY DONATIONS

INFORMATION FORM Please fill in the following form, ticking or deleting where appropriate, and return it to the Admissions Administrator. How many children will you have in the school in September 2019 Payment of the Parental Voluntary Contribution will be made by:

Standing Order (Completed Standing Order Mandate Enclosed)

Cheque – termly (enclosed 3 posted dated cheques dated

1st September 2019, 1st January 2020 and 1st April 2020)

Cheque – yearly (enclosed 1 cheque)

Cash Payment by cash

Monthly on the 1st of every month

Termly on the 1st September 2019, 1st January 2020 and 1st April 2020

Yearly on the 1st September 2019

Gift Aid Declaration enclosed Student’s Name: ______________________________________________________ Parents’ Name: _______________________________________________________ Signed………………………………………………….... Dated……………………………………………………

We are required by law to point out to you that you are not legally obliged to make your contribution nor does failure to make a contribution mean that your child will be treated any differently as a result.

KANTOR KING SOLOMON HIGH SCHOOL

STANDING ORDER MANDATE

Students / Name(s) 1…………………………… 2……………………………..

3…………………………… 4……………………………..

Address of Parent(s)…………………………………………………………………

………………………………………………………………………………………..

To The Manager ………………………………………… (Bank/Building Society)

Full Address ………………………………………………………………………….

…………………………………………………Postcode……………………………

Account Name ……………………………………………………………………….

Branch Sort Code ……..-……..-…….. Account Number………………………...

Please Pay: Lloyds Bank plc, Brook Street Sort code number 30-91-37

For the credit of: King Solomon High School, Redbridge, IG6 3HB

Account Number: 00419344

Registered Charity. Company No. 2784298

Amount of Monthly Payment £...............

Frequency Commencing 1st September 2018 and thereafter monthly until

further notice

This instruction cancels any previous standing orders

for King Solomon High School

Signature(s) ............................................ Date .......................

............................................ Date .......................

For School and Bank/Building Society Office Use Only

Quoting the Reference ...................................