APPLICATION FOR ADMISSION SEPTEMBER 2021 SUPPLEMENTARY INFORMATION FORM Please make sure that you have read the document entitled “Admission to Leventhorpe – September 2021” which includes the admission criteria. The questions on this form relate to that document. You should apply under more than one criterion if you can.
STUDENT
Surname: …………………………………….….. First name(s): …………………………………………
Date of birth: …………………………………….. Male/female: ………………………………………….
Address: …………………………………………………………………………………………………………………..
………………………………………..… County: ……………………… Postcode: …………......
Is this the student’s permanent address? → Yes / No
Current Primary School: …………………………………………………………………………………………………
PARENTS / CARERS
Names: …………………………………………………………………………………………………………………….
Home Tel No: ……………………………………... Daytime/Mob Tel No: ………………………......
Address (only if different from the student’s): ………………………………...…………………………………….…
………………………………………………………………………………………………………………………………
Email Address……………………………………………………………………………………………………………. We will use your email address and other contact details to communicate with you during the application process.
APPLICATION OF ADMISSION ARRANGENTS PLEASE TICK ALL THE CRITERIA FOR WHICH YOU QUALIFY
1. LOOKED AFTER CHILDREN If you are applying under criterion 1 (looked after children – England and Wales) please tick this box 2. LOOKED AFTER CHILDREN If you are applying under criterion 2 (looked after children – abroad) please tick this box 3. BROTHERS / SISTERS CURRENTLY ATTENDING LEVENTHORPE Name(s) Form(s) in 2020/2021
……………………………………………………. ……………………………………………………
……………………………………………………. ……………………………………………………
If you are applying under criterion 3 (sibling) please tick this box
4. CHILDREN OF STAFF If you are applying under criterion 4 (children of staff) please tick this box Name of parent employed by the school: ………………………………………………………………………………
Date Employment Commenced: …………………………………………………………………………….…………..
5. NAMED PRIORITY SCHOOL If you are applying under criterion 5 (priority school) please tick this box (Priority schools are Hatfield Heath, High Wych, Little Hallingbury, Mandeville, Reedings, Spellbrook, St Andrews (Much Hadham) and Sheering)
6. RESIDENTS OF THE PARISHES OF GILSTON AND EASTWICK If you are applying under criterion 6 of the admission criteria (Gilston and Eastwick) please tick this box
7. DISTANCE If you are applying under criterion 7 of the admission criteria (distance) please tick this box
8. MUSICAL APTITUDE If you wish to apply under criterion 8 of the admission criteria (musical aptitude) please tick this box Note. Those applying on the basis of musical aptitude will be required to take a musical aptitude test during October 2020 at a venue to be advised. It is expected that students applying to the school under this criterion are committed to participating fully in the musical life of the school.
Declaration and Signature
I confirm that the details I have given on this form are true to the best of my knowledge and belief and understand that an offer may be withdrawn if false information has been given on this form. Information provided on this form may be shared with appropriate 3rd parties (e.g. Hertfordshire or Essex Local Authorities) in connection with the correct processing of my application.
Please sign: …………...………………………………………………………………………………………………… Parent/Carer
Please print your name: ………………………………………………………………………………………………..
Date: ………………………………………………
Please return this form fully completed to: Admissions, Leventhorpe, Cambridge Road, Sawbridgeworth, Herts. CM21 9BY no later than 31st October 2020 or by 4pm on Friday 2nd October 2020 if applying under the Musical Aptitude Criterion
Note: You must also complete a Secondary Transfer Form through your Local Authority.
If you are a Hertfordshire resident the admissions booklet can be viewed or downloaded at www.hertfordshire.gov.uk/admissions. Parents who have difficulty accessing the online form should telephone 0300 123 4043.
If you are an Essex resident the admissions booklet can be viewed or downloaded at ww.essexcc.gov.uk/admissions. Parents who have difficulty accessing the online form should telephone 0845 603 2200.
If you are resident in any other area or do not have access to an online system, please contact Admissions at the school.