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This application form is for children who currently have an Education, Health and Care Plan (EHCP) issued by Surrey County Council. If your child does not have an EHCP, or is currently under assessment, please apply for a school place. If your child is Year 2 with an EHCP and is attending a primary school, you do not need to complete this form. If you are Year 11 with an EHCP and are moving on to college, you do not need to complete this form. Please refer to the SEND Admissions page on the Surrey County Council website for further guidance, or contact your local SEND team.

If you would like your child (Y6 or Y11) to continue at their current school for the next key stage then you should put this as your first and only preference. Providing the school continues to be suitable for your child's needs then they will not be expected to move schools.

Before completing this form please ensure you have read through the School Admissions Guidance for Children with an EHCP booklet.

If you would like to see how we use your personal data please read our privacy notice.

1. Your child's details

Gender *
Please indicate the key stage your child will be starting in September 2020 (not their current key stage): *

Child's home address

This must be the child's normal place of residence or in cases of shared custody, the address at which a child spends the majority of their time.

Does your child have a sibling applying for a place in the same academic year?

2. Children in public care

Is the child looked after or previously looked after, according to the definitions below:
  • Looked after children are those who are registered as being in the care of a local authority or provided with accommodation by a local authority in accordance with section 22 of the Children Act 1989(a) at the time an application for a school is made, for example, children who are fostered or living in a children's home.
  • Previously looked after children are those who have previously been in the care of a local authority in accordance with Section 22 of the Children Act 1989(a) and who have left that care through adoption, a child arrangement order (in accordance with section 8 of the Children Act 1989 and as amended by the Children and Families Act 2014) or special guardianship order (in accordance with section 14A of the Children Act 1989).

    3. School Preferences

    Please name the school(s) you would like the Local Authority to consider for a place for your child. You may give up to two preferences. The second preference will be considered if it is not possible to place your child at your first preference school.

    Please note:

    • If your child is currently at a school that continues for the next key stage and you would like them to remain at the school, please put this school as your first and only preference.
    • If you would like to apply for the specialist centre within a mainstream school please specify this.
    • If you would like your child to attend a mainstream school but do not know which one, you can write 'mainstream.' The Local Authority will then approach the nearest mainstream school to your child's home address.
    • If you think that there are any exceptional reasons why your child should attend a particular school, please indicate them in the boxes.

    For more information about the types of school you can express as a preference, and how the Local Authority will consider your preferences please see the School Admissions Guidance for Children with an EHCP booklet.

    Will your child have a sibling at this school in September 2019?
    Will your child have a sibling at this school in September 2020? *
    Will your child have a sibling at this school in September 2019?
    Will your child have a sibling at this school in September 2020?

    5. Parent/guardian/carer's details

    Do you have parental responsibility for this child? *
    Relationship to the child? *
    6. Declaration of parent/guardian/carer
    By submitting this form, I certify that I am the person with parental responsibility for the child named in Section 1 and that the information given is true to the best of my knowledge and belief. I understand that if I give any false or deliberately misleading information on this form and/or supporting documents, or withhold any relevant information by not informing my caseworker of any changes to information immediately, this may render my application invalid and/or lead to the withdrawal of a school place offer. I understand that the Local Authority will consider my preferences in accordance with the SEND Code of Practice (2014). I give permission for the Local Authority to also consult with other schools/education professionals for my child as appropriate. I have read and understood the Travel Assistance policy for pupils with SEND and I understand that if my school place request is not for the nearest appropriate provision then my child will not be entitled to assistance with travel.
    Please ensure this form is submitted by 30 September 2019.
    You should note:

    1. This form is for applicants whose Education Health and Care Plan is maintained by Surrey County Council only.

    2. If you are applying for a school place for twins or other children from a multiple birth you must complete a separate application for each child.

    3. The address on the front of the form must be the child's permanent place of residence. In cases of shared custody, the address should be the one at which the child spends majority of their time. An application can only be made from a single address and only one application can be made for each child.

    4. A sibling will be considered to be a brother or sister (that is, another child of the same parents, whether living at the same address or not), a half-brother or half-sister, or a step-brother or step-sister, or an adoptive or foster sibling ordinarily living as part of the same family unit at the same address. A child will be given sibling priority if they have a sibling on roll at the school concerned and that sibling is still expected to be on roll at that school at the time of the child's admission.

    5. In considering your school requests, you should also note Surrey's Travel Assistance Policy for Children and Young People with SEND . If the school you request is not the nearest appropriate provision to your home address, this will affect your child's eligibility for travel assistance.

    6. If you are unsure whether you have parental responsibility for the child please see Government issued guidance on parental rights and responsibilities

    7. Moving house - If you move at any time after submitting your application, you must inform your caseworker in writing with evidence of your new address. This may affect the way your application will be considered.

    8. If you would like any advice on completing your form, please contact your SEND caseworker.

    Personal Information Policy

    For more information about how we use your information please see our Corporate Privacy Notice and the Children, Schools and Families Privacy Notice.

    If you have completed all the fields marked *, then please click "Submit".

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