North Liverpool Academy Application Form

Application for Admission Part 1/4 - Student Details

Please complete all sections of the form.

Surname	Postcode
Forename	Home Telephone Number
Other Names	Work / Mobile Number
Date of Birth	Has your child seen any of these people?
Year Group	Is your child undergoing assessment for SEN?
Gender	Current School
Home Address	Does your child have an SEN? *SEN - Special Educational Needs
Data Protection Act 1998 The information you provide on this form will be passed to the Local Education Authority. The Education Authority is registered under the Data Protection Act 1998. The registration is primarily for the collection and analysis of statistical data. The Education Authority may collect and share this information with other organisations for the purpose of administration, statistical and research purposes. This will allow the Education Authority and its partners to monitor performance, improve quality and plan future provision.