Staff/Office Use Only			
Learner Name:			
ID Proof:	Student ID:

	2020-21 – Enrolment Form
and Learning Agreement
(Year 10 & Year 12)	

PLEASE USE BLOCK CAPITALS  –  NO CORRECTION FLUID (EG TIPPEX)  –  PLEASE TICK APPROPRIATE BOXES
COMPLETE ALL SECTIONS UNLESS OTHERWISE STATED – THIS INFORMATION WILL BE HELD CONFIDENTIALLY
IF YOU NEED HELP TO COMPLETE THIS FORM, PLEASE ASK A MEMBER OF STAFF	
SECTION 1: BASIC DETAILS	
Legal Forenames (IN FULL):	Legal Surname:	
Title:	Surname at Birth (if different):	
	Gender    Male    Female   	
Date of Birth 
(dd-mm-yyyy)									Prefer to be known as:  	
	
SECTION 2: REGISTRATION - Staff Use Only	
Registration Group:	Unique Learner Number:	
Year Group:	Year Taught In:	
Enrolment Status:	Admissions Number:	
Admission Date:	Attendance Mode:	
UPN:		
SECTION 3: ADDRESSES	
Current Home Address:

Postcode:	Additional Address:

Postcode:	
Date From:	Date To:	Date From:	Date to:	
SECTION 4: PRIMARY CONTACT INFORMATION (EMERGENCY CONTACT 1)	
Contact Details	Contact Priority (tick Primary)	
Title & Name:		
Relationship to Student:		
Mobile Telephone:		
Email Address:		
Home Telephone:		
Work Telephone:		

SECTION 5: FAMILY/HOME	
Priority	Name	Relationship	Telephone	*Court Order	
2					
3					
4					
5					
* Please tick if the contact has any current Court Orders which relate to the student.	
SECTION 6: DIETARY	
Special Dietary Needs:

	Eligible For Free School Meals:         Yes        No
Start Date:                                     End Date:	
	Meal Arrangements:
Free School Meal          
Paid School Meal          
Packed Lunch                	
SECTION 7: MEDICAL	
Medical Practice:	Tel Number:	
Address:	
Does the student have any of the health problems or disabilities below?	  Yes	  No	If YES, please tick 	
 Visual impairment 
 Hearing impairment 
 Profound complex disabilities 
 Mental health difficulties 	 Asperger’s syndrome 
 Social/Emotional difficulties 
 Temporary disability after illness 
 Disability affecting mobility 
 Other specific Physical difficulty 	 Other Medical Condition
 (Please state) 

_______________________	
Additional Notes:

	
SECTION 8: ETHNIC/CULTURAL	
Choose one option which best describes your ethnic group or background	
White
	Asian/Asian British	Black/African/
Caribbean/Black British	Mixed/Multiple
Ethnic Groups	Other Ethnic group	
 English/Welsh/Scottish/
      Northern Irish/British (31)
 Irish (32)
 Gypsy or Irish   
      Traveller (33)
 Any other White     
      Background (34)	 Indian (39)
 Pakistani (40)
 Bangladeshi (41)
 Chinese (42)
 Any other Asian   
      Background (43)	 African (44)
 Caribbean (45)
 Any other Black/
      African/Caribbean    
      Background (46)	 White and Black 
       Caribbean (35)
 White and Black 
       African (36)
 White and Asian (37)
 Any other Mixed/
      Multiple Ethnic 
      Background (38)	 Arab (47)
 Any other Ethnic 
      group (98)	
First Language:	Home Language:	Religion:	
Nationality:	Passport Number:	Passport Expiry Date:	
Is English an Additional Language?	Is Traveller Status?	
SECTION 5: FAMILY/HOME CONTACT INFORMATION	
SECTION 9: ADDITIONAL INFORMATION	
Learning Needs	
Does the student have any of the learning needs below?	  Yes	  No	If YES, please tick 	
 Severe learning difficulty 
 Moderate learning difficulty 
 Autistic spectrum disorder 
 Other specific learning difficulty 	 Dyslexia 
 Dyscalculia 
 Social/Emotional difficulties 
 Speech, Language and Communication Needs	 Other Medical Condition
 (Please state) 

_______________________	
If you have indicated multiple personal needs above, which would you say affects you more severely 		
Does the student have any of the following	 139A Assessment	 Education/Health Care Plan	 SEN Assessment	
	Date Awarded:	
Travel Arrangements to School (tick all that apply)	
   Bicycle	   Train	   Car/Van	   Walk	   Public Transport	
   Car Share	   Public Bus Service	   Taxi	   Other (please specify)	
Sexual Relationship Education	
	I give permission for my child to receive sexual/relationship education within the school curriculum.	
SECTION 10: WELFARE	
In Care:                                   Yes            No	Start Date:                                      End Date:	
Notes:	
Young Carer:                         Yes            No	Start Date:                                      End Date:	
Notes:	
Child Protection Plan:        Yes            No	Start Date:                                      End Date:	
Notes:	
SECTION 11: SCHOOL HISTORY	
Previous Schools	Start Date	Leaving Date	Reason for Leaving	

				

				

SECTION 12: PARENTAL CONSENT - Visits	
Off Site Day Time Visits:
The student agrees to adhere to all safety, security and other instructions given by a member of staff, whilst participating in out of school activities, for the duration of the visit.    Yes

The Parent/Guardian agrees to the student participating in ‘out of college activities’ throughout the academic year.   Yes   No

Change of circumstances
It is the Student’s/Parent’s responsibility to notify the school if there is a change in medical conditions or change of address.

Refunds
Please note that any money paid for off-site visits will not automatically be refunded; individual circumstances will be taken into consideration.	
	SECTION 13: STUDY DETAILS 	
Please tick your preferred Vocational option. 	
Year 10 Students	
	Subject	Subject Detail	 Selected	Comments	
Mandatory	English Language	AQA - GCSE	P		
Mandatory	English Literature	AQA - GCSE	P		
Mandatory	Maths	EDEXCEL - GCSE	P		
Mandatory 	Combined Science 	AQA - GCSE	P		
Mandatory	Business Studies	BTEC	P		
Mandatory	Personal Development	BTEC	P		
Vocational Course Option	Motor Vehicle	LEVEL 1			
Vocational Course Option	Construction	LEVEL 1			
Vocational Course Option	Hair & Beauty	LEVEL 1			
Mandatory	PSHE	NON-EXTERNALLY ASSESSED	P		
Mandatory	PE	NON-EXTERNALLY ASSESSED	P		
Year 12 Students	
Mandatory	English 	FUNCTIONAL SKILLS L2	P		
Mandatory	BTEC Employability	EDEXCEL - GCSE	P		
Mandatory	Maths	FUNCTIONAL SKILLS L2	P		
Vocational Course Option					
Vocational Course Option	
				
Vocational Course Option					

SECTION 14 – USE OF PHOTOGRAPHIC IMAGES CONSENT	
Occasionally, we may take photographs of the students. We may use these images in our publicity or the schools prospectus or in other printed publications as well as on our website. We may also make video or webcam recordings for school-to-school conferences, monitoring or other educational use. 

From time to time, our school may be visited by the media who will take photographs or film footage of a visiting dignitary or other high profile event. Students will often appear in these images, which may appear in local or national newspapers, websites or on televised news programmes. 

To comply with the GDPR Data Protection Act, we need your permission before we can photograph or make any recordings of your child. Please answer the 5 questions below. 	
•	May we use your child’s photograph (unidentified) in the school prospectus and other printed publications that we produce for promotional purposes?	 Yes            No	
•	May we use your child’s image (unidentified) on our website or Social Media?	 Yes            No	
•	May we record your child’s image (unidentified) on video or webcam?	 Yes            No	
•	Do you consent to your child being photographed or filmed in press events agreed by the school?	 Yes            No	
•	Do you consent to your child’s full name being published with a press photograph? (At the present time, some local newspapers will not agree to publish a photograph without a full name) 	 Yes            No	
Please note that websites can be viewed throughout the world and not just in the United Kingdom where UK law applies. 
Unidentified above means we will only use the first name. Please also note that the conditions for use of these photographs are below.	
Use of Photographic Images Conditions

1.	This form is valid for four years from the date you sign it, or for the period of time your child attends this school or setting. The consent will automatically expire after this time. It is your responsibility to let us know if you want to withdraw or change your agreement at any time. 

2.	We, the school, will not use the personal details or full names (which means first name and surname) of any child in a photographic image on video, on our website, in our school prospectus or in any of our other printed publications. 

3.	We will not include personal e-mail or postal addresses, or telephone or fax numbers on video, on our website, in our school prospectus or in other printed publications. 

4.	If we use photographs of individual students, we will not use the name of that child in the accompanying text or photo caption, unless we have your agreement. 

5.	If we name a student in the text, we will not use a photograph of that child to accompany the article. 

6.	We may include pictures of students and teachers that have been drawn by the students. 

7.	We may use group or class photographs or footage with very general labels, such as “a science lesson” or “making Christmas decorations”. 

8.	We will only use images of students who are suitably dressed, to reduce the risk of such images being used inappropriately. 

9.	As the child’s parents/carers, we agree that if we take photographs or video recordings of our child/children which include other pupils, we will use these for personal and family use only. I/we understand that where consent has not been obtained from the parents for any other use, we would be in breach of the Data Protection Act if we used our recordings for any wider purpose.

SECTION 15: SIGNATURES,AGREEMENTS AND USE OF INFORMATION	
The information you provide on this form is subject to the current GDPR Data Protection Act. You are requested to read the statement below: 
PRIVACY NOTICE – HOW WE USE YOUR INFORMATION - The personal information you provide is passed to the Department for Business, Innovation and Skills. Where necessary it is also shared with the Department for Education, including the Education Funding Agency. The information is used for the exercise of functions of these government departments and to meet statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009, and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). The information you provide may be shared with other organisations for education, training, employment and well-being related purposes, including for research. You may be contacted after you have completed your programme of learning to establish whether you have entered employment or gone onto further training or education. Further information about use of and access to your personal data, and details of organisations with whom we regularly share data are available at https://www.gov.uk/government/publications 

CONSENT TO PROCESS - I agree to Stephenson Studio School processing personal data contained in this form, or other data which the School may obtain from me or other people, whilst a school student. I agree to the processing of such data for any purposes connected with school studies or health and safety whilst a student of the school or for any other legitimate reason. Additionally I agree that Stephenson Studio School may contact me upon completion of my course(s) to obtain information on the outcome such as further learning or employment.

Consent for the Use of Biometric Technology: 
•	I give permission for my child to use the school’s biometric identification systems for access around the school. (Door sensor)
•	I understand that the school will keep this data in accordance with the protection of freedom act 2012 and the data protection act 1998.
•	I acknowledge that my child has the right to refuse their biometric information being used and the child’s objection or refusal overrides any parental consent.

HOME SCHOOL AGREEMENT
Stephenson Studio School recognises that the successful development of its pupils depends on an effective partnership of the Studio School, students and parents. All three parties share responsibility for the development and achievement of each pupil. Together, we commit ourselves to the following:

As parent/carer, I/we will: 
•	Make sure my/our child attends school in correct uniform, arrives on time and is properly equipped for school 
•	Encourage my/our child to work hard and support them in homework by checking and signing the planner each week 
•	Ensure that my child reads and completes their weekly reading log
•	Attend subject parent evenings and progress review days to discuss my/our child’s progress 
•	Adhere to the Studio School’s policies and procedures as published on the schools website
•	Allow my/our child to attend school educational visits 
•	Agree to my/our child’s photograph or film/video footage being taken for the school’s use 
•	Encourage my/our child to participate in the extracurricular opportunities offered by the school 
•	Promote the schools vision, values and ethos

I confirm that, to the best of my knowledge, the information on this form is correct and I agree to the terms of the agreement.	
Parent/Guardian Signature:	Print Name:	Date:	
Parent/Guardian Signature:	Print Name:	Date:	
As a student, I will: 
•	Be an ambassador for Stephenson Studio School and commit to the student pledge
•	Work hard in class and at home, so that I can achieve my full potential and be the best I can
•	Treat others as I would wish to be treated 
•	Be proud of my school and respect the school environment and the local community
•	Attend the school in correct uniform, be on time, properly equipped and ready to learn
•	Use my planner to organise my homework, coursework, record my achievements and maintain my reading log
•	Adhere to the school rules, behave responsibly and be polite and respectful to others in the school and within the wider community 
•	Understand that any misbehaviour whilst wearing school uniform will be dealt with as per the schools behaviour policy 
•	Take part in extra-curricular activities offered by the school 
•	Complete homework on time 
•	Promote the schools vision, values and ethos	
Student Signature:	Print Name:	Date:	
The Studio School will: 
•	Provide a learning environment that is stimulating, safe and caring 
•	Treat everyone with respect 
•	Ensure that each pupil has the opportunities, support and guidance to achieve his/her full potential 
•	Report regularly on each pupil’s progress 
•	Expect high standards, set clear rules, promote mutual respect and develop a sense of responsibility 
•	Keep parents informed about school matters, be welcoming to enquiries and responsive to concerns 
•	Record and reward good progress and performance 
•	Provide opportunities that will develop broader skills to prepare for life and the world of work 
•	Detain your child until 4.00 pm where necessary 
•	Inform you if your child has detention rather than attending enrichment if he/she fails to meet the Studio School’s standards 
•	Promote the schools vision, values and ethos.	
STEPHENSON STUDIO SCHOOL REPRESENTATIVE
I confirm that, to the best of my knowledge, the information on this form is correct and that the Student and Parent/Guardian has been supported in the completion of the enclosed declared information and the student is eligible to enter the course detailed herein.	
Tutor\Staff Signature:	Print Name:	Date:	
Head/Deputy Head Signature:	Print Name:	Date: