Data Form

Personal Information Form 2020/2021

1. Legal Forename and Surname (as shown on the birth certificate or passport) *

2. Date of birth

YYYY

3. Religion

4. Home language (if not English)

5. Ethnicity

6. Year Group

7. Class Teacher and Room for 2020/2021

8. Address and postcode

CONTACT INFORMATION – APPLIES TO THE PERSON IN CHARGE OF PUPIL
Please give details of all persons who have parental responsibility and anyone else you wish to be contacted in an emergency.
Place them in order of contact priority. For example, you may wish to put the mother or father in the 1st and 2nd boxes.

Please add the following details below for your first contact:

1 - Parent Contact Name (i.e Mrs X Xxxx)
2 - Relationship To Child (i.e Mother)
3 - Address & Postcode (if different from pupil's)
4 - Email address (required to set up a cashless system)
5 - Mobile Telephone Number (required to set up a cashless system) - please include a daytime contact number too - as many as possible.

10.

Second contact:

1 - Parent Contact Name (i.e Mr X Xxxx)
2 - Relationship To Child (i.e Father)
3 - Address & Postcode (if different from pupil's)
4 - Email address
5 - Contact telephone numbers (as many as possible.)

11.

Third contact:

1 - Parent Contact Name (i.e Mrs X Xxxx)
2 - Relationship To Child (i.e grandparent, aunt, uncle, partner, childminder)
3 - Address & Postcode (if different from pupil's)
4 - Email address
5 - Contact telephone numbers (as many as possible.)

12.

Fourth contact:

1 - Parent Contact Name (i.e Miss X Xxxx)
2 - Relationship To Child (i.e grandparent, aunt, uncle, partner, childminder etc)
3 - Address & Postcode (if different from pupil's)
4 - Email address
5 - Contact telephone numbers (as many as possible.)

13. If you have a Brother / Sister of the above pupil attending this school, please add below
1. Name
2. Class Teacher

Medical Information

14. Medical Surgery and Doctor's Name

15. Specific Medical Problems i.e diabetic/asthmatic/allergies
(If asthmatic, please let us know if there is an inhaler in the child's school bag)

16. Any other additional medical information the school should be made aware of:

17. Do you give permission for important medication information to be shared with school staff who are in contact with your child?

Yes

18. Do you give permission for first aid to be given if necessary as outlined in our policy?

Yes

For prescribed medication that your son or daughter may need or must take during school hours a Parental Agreement Form for Administration of Medicines must be completed and retained in the school office. If you have any questions, please call the office.

The School intends to keep parents fully informed in line with the following policies: Education Reform (Northern Ireland) Order 1989, Children (Northern Ireland) Order 1995, Education (Northern Ireland) Order 1996 and subsequent Orders, Code of Practice for Children with Special Educational Needs, Child Protection Pastoral Care in Schools 1999 and Freedom of Information Act 2000.

Parental Responsibility Information

“Parental Responsibility is all the rights, duties, powers and responsibilities and authority which by law a parent of a child have in relation to the child and his/her property.” (Children (NI) Order 1995 article 6 (1))

Under current Human Rights, Code of Practice for Children Protection legislation, Strandtown School requests you to list all persons who have parental / legal access to be invited to parental interviews / events, receive pupil reports or be kept informed of school progress. Strandtown School is aware how sensitive situations can be at times or parental separation, particularly if arrangements have to be instituted resulting from legal action, or court decision. Only those named below will receive such information. It is important that you sensitively complete the following sections.

19.

The following adults have Parental Rights / Legal Access / must be informed - please complete below the following information in the box below:

Mother - Full Name - Address
Father - Full Name - Address (If different to Mother)

20. Are there Court Orders which relate to the child? (These include Custody Orders, Contact Orders, Residence Orders under the Children (NI) Order 1995)

If YES, please state what they are and the implications in the Comment box.

Yes

Comment

General Data Protection Regulation 2018: The school is obliged to comply with the General Data Protection Regulation (GDPR). We will process your personal information on the legal basis that it is part of our GDPR policy to do so. We have a duty to protect this information and to keep it up to date. The school is required to share some of the data with the Education Authority, with the Department of Education (DENI) and Public Health Authority (PHA). A copy of the GDPR policy is available on our website.

To enable us to comply with our obligations under GDPR, we require your consent to hold the information included in this form. You will be asked to complete a new form at the start of each academic year while your child attends this school. If your circumstances change, i.e. change of address, you should contact the school office to request a new form. This form should be signed by someone with parental responsibility wherever possible. If you have provided details of anyone other than yourself, please let them know that the school holds their details.

21. Signed:

22. Relationship to Pupil

23. Dated

YYYY

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