<p>Common Application Form Holyport College</p><p>Year 9 Entry September 2015 – Apply by 31 October 2014 For children with dates of birth between 1 September 2001 and 31 August 2002 If you are applying for a Year 9 boarding place from outside of RBWM, you will need to complete this form in addition to the Supplementary Information Form. </p><p>Your child’s details Please fill in this form using black or blue ink and CAPITAL LETTERS</p><p>Surname: Middle name(s):</p><p>First name:</p><p>If your child has been known by another name please enter it here:</p><p>Day Month Year Female Male Date of birth: Gender:</p><p>Your child’s current Name: Town: school:</p><p>Address details Your child’s permanent House name / number: address and postcode</p><p>We will carry out checks to Street: verify your home address and any place gained by Town / Village/County: using a false address will be withdrawn. Postcode: Council Tax Reference:</p><p>Moving address Please fill in this section if you are planning on moving House name / number:</p><p>Street: Your new address Town / Village/County:</p><p>Postcode: Council Tax Reference:</p><p>When are you moving to your new address? Day Month Year</p><p>If you are a Service/Crown Servant family, please tick here and provide evidence of posting You must provide evidence of your new address as soon as you have it. You must also inform us immediately if there is any change to your planned move.</p><p>APPLICATION DEADLINE – 31 OCTOBER 2014 Parent/Carer details Mr/Mrs/Miss/Ms Initial Surname</p><p>Home Tel. No. Mobile Tel. No</p><p>Email Relationship to Child</p><p>Other details Please tick the appropriate box below for each question</p><p>Does your child have a statement of special educational needs? Yes No</p><p>Is your child in the care of the Local Authority? (If yes, please attach Yes No documentary evidence)</p><p>Are there any exceptional social/medical reasons why your child should Yes No specifically attend one of your preferred schools? (If yes, please provide all information and evidence requested as detailed in the ‘Guide to Secondary, Middle and Upper Schools’) Day Month Year If your child currently attends a Windsor Middle school please give date of entry to this school.</p><p>You can apply for Holyport College as a day and/or boarding student. Please specify whether you are applying as a day or boarding pupil. You can list both Holyport College Day Student and Holyport College Boarder but these must be separate preferences.</p><p>Office use Preference 1</p><p>Office use Preference 2</p><p>Preference 3 Office use</p><p>You have the right to provide reasons for your preference. If you wish to do so, please use the box below to list your reasons. These should relate to the published admissions policy for the school.</p><p>Sibling information Does your child have a sibling (brother or sister – this includes half, Yes No adopted, or foster sibling) attending your preferred school?</p><p>If you have ticked yes, please provide details below: Name Date of Birth School Attending</p><p>Sibling 1</p><p>Sibling 2</p><p>APPLICATION DEADLINE – 31 OCTOBER 2014 Declaration</p><p>I confirm that the information given on this form is correct and that I am the parent/carer of this child.</p><p>I enclose: a) supporting evidence if applying for a looked after child b) supporting evidence if applying under social / medical grounds c) If I am moving house, confirmation that my house purchase is legally binding or a formal lease agreement and evidence that I have completed the sale of, or ceased rental at my previous property. I have also enclosed a copy of a utility bill or current council tax statement to prove that I am living in my new property</p><p>Data Protection Act 1998 – The personal information collected on this form will be used by RBWM for the administration of school admissions. This information will only be shared with schools and other local authorities for the purposes of applying their admissions policy. The Council may also use this data in connection with the prevention or detection of other fraud or crime.</p><p>Your signature:</p><p>Your full name:</p><p>Day Month Year Date:</p><p>Please send your completed form to : School Admissions The Royal Borough of Windsor & Maidenhead Town Hall St Ives Road Maidenhead SL6 1RF</p><p>And a copy to: Admissions Holyport College Ascot Road Holyport Berkshire SL6 3LE</p><p>We advise that you keep a copy of the application form for your own reference. If you require confirmation of receipt you MUST enclose with this form a stamped addressed envelope. If you require any assistance with completing this form please call the RBWM Customer Service Centre on 01628 683870.</p><p>APPLICATION DEADLINE – 31 OCTOBER 2014</p>