Admission to Adams Grammar School

Adams’ Grammar School REGISTRATION FORM FOR YEAR 8, 9 AND 10 - 2017/2018 (Please place your son on our list of interest) Please complete in Capital Letters Please indicate your admission preference below (tick the relevant box):- Year Group Applying For: Day Place: Boarding Place: Boy’s Surname: Boy’s Forenames: Date of Birth: Mr/Dr Relationship to Child: Full Names of Parents/Carers: Mrs/Ms/Dr Relationship to Child:

Home Address (where the boy normally resides on weekdays and nights): Postcode: Daytime Telephone: Evening Telephone: Mobile Telephone: Email Address: Name and Address of Present School: Postcode:

SPECIAL ARRANGEMENTS: Parents who consider their son has a disability under the terms of the Equality Act 2010 and/or a special educational need which would disadvantage him in the admissions process should contact the school to request a Special Arrangements Form. Any request will only be considered with a completed Special Arrangements Form, which must be returned with supporting evidence from third parties (e.g. doctor, specialist consultant, Local Authority, etc). It is yours (and not the School’s) responsibility to provide all relevant evidence. Please note all information must be submitted with the Registration Form so consideration can be given to any special arrangements or reasonable adjustments. If the form has not been completed and returned to the School by the deadline NO special arrangements can be considered for your son.

CHILDREN IN PUBLIC CARE OR ADOPTED; ALSO ELIGIBILITY FOR PUPIL PREMIUM

Public Care: If your son is in, or ever has been in public care, please name the Local Authority……………………………………………………………………………… If your son is adopted, was he in public care prior to adoption? YES / NO (if adopted please delete one)

Is your son eligible for Pupil Premium, or are you classed as a service family? YES / NO Confirmation:

 I wish to apply for my son to be placed on the List of Interest for admission to Year 8/9/10 (please circle the year your son is applying for)  I confirm I have read and understood and agree to the Admissions Policies for the academic year 2017-18 for the school.  I confirm all of the information given on this form is correct and I understand that the inclusion of false information disqualifies the registration.  I confirm that I am happy for all personal data to be shared with the relevant Local Authorities. Signature of Parent/Carer: ______Date: ______

COMPLETE AND SIGN THIS REGISTRATION FORM AND ANY SUPPORTING DOCUMENTS REGARDING SEN/PUPIL PREMIUM AND RETURN TO: ADAMS’ GRAMMAR SCHOOL, ADMISSIONS, HIGH STREET, NEWPORT, SHROPSHIRE, TF10 7BD TOGETHER WITH AN EMAIL ADDRESS IF YOU REQUIRE AN ACKNOWLEDGEMENT OF SAFE RECEIPT OF YOUR REGISTRATION FORM.