Registration – Elevated Futures.Ed

Pupil Registration Form

Elevated Futures Education Post-16 Provision

Please complete all sections. This document is confidential.

Elevated Futures Student Registration

Please complete all sections. This document is confidential.

1: Student Details

Student Legal Name(Required)

First Last

Chosen Name

Date of Birth(Required)

MM slash DD slash YYYY

Gender(Required)

Religion (Optional)

First Language(Required)

Ethnicity

Permanent Home Address(Required)

Street Address Address Line 2 City Borough Post Code Country

2: Parent/Carer Details

Primary Parent/Carer Name(Required)

First Last

Primary Parent Email(Required)

Primary Mobile Number(Required)

Additional Contacts

Name	Relationship to Student	Mobile Number	Email	Actions

There are no Entries.

Maximum number of entries reached.

3: EHCP & SEND Info

In Reciept of an EHCP

Yes

In Assessment Process

Date Current EHCP Finalised

MM slash DD slash YYYY

Primary Need(Required)

Local Authorising (Issuing)

Upload EHCP Document

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 128 MB, Max. files: 3.

4. Educational History

Most Recent / Secondary School(Required)

Name of School

Date Attended(Required)

MM slash DD slash YYYY

Previous Settings

Name of School/Setting	Dates Attended	Reason for Leaving	Actions

There are no Entries.

Maximum number of entries reached.

Primary School (Key Stage 1/2)(Required)

Name of School

Date Attended(Required)

MM slash DD slash YYYY

Early Years / Nursery (EYFS)(Required)

Name of School

Date Attended(Required)

MM slash DD slash YYYY

Reasons for leaving previous setting (if applicable)(Required)

e.g. Moved area, exclusion, medical needs, needs not being met

5: Medical & Specialist Services

Doctor/GP Name(Required)

Surgery/Address/Tel(Required)

Medical Conditions & Allergies(Required)

Please list any diagnosed conditions, allergies (and reaction type) or regular medication.

Dietary Requirements

e.g. Vegetarian, Gluten Free, Halal...

External Agency Involvement(Required)

Social Care

Early Help

SaLT

CAMHS

YOT/YOS

SpLD Support

Other

If Other, please specify details

6: Permissions

(Required)

I give permission for my child to be photographed/filmed for educational purposes (Assessment evidence).

I give permission for my child to be photographed/filmed for marketing (Website/Brochure).

I give permission for my child to access the internet under supervision, in line with the Acceptable Use Policy.

I give permission for my child to take part in local off-site visits (walking distance).

7: GDPR & Declaration

The personal data collected on this form is required to process your child's registration and provide appropriate education and support in accordance with the Education Act 1996 and Children's Act 2004. Elevated Futures Education is the Data Controller. We will share this information with the Local Authority, NHS services, and other educational bodies where legally required or necessary for the safeguarding and wellbeing of the student. Data will be stored securely in line with the General Data Protection Regulation (GDPR) 2018. You have the right to request access to the data we hold about you and your child. By signing below, you consent to us processing this data for these purposes.

Signature(Required)

Parent/Carer (Type Name)(Required)

Date Signed(Required)

MM slash DD slash YYYY

(Click to save a copy for your records before submitting)

Elevated Futures Student Registration

Please complete all sections. This document is confidential.

1: Student Details

Student Legal Name(Required)

First Last

Chosen Name

Date of Birth(Required)

MM slash DD slash YYYY

Gender(Required)

Religion (Optional)

First Language(Required)

Ethnicity

Permanent Home Address(Required)

Street Address Address Line 2 City Borough Post Code Country

2: Parent/Carer Details

Primary Parent/Carer Name(Required)

First Last

Primary Parent Email(Required)

Primary Mobile Number(Required)

Additional Contacts

Name	Relationship to Student	Mobile Number	Email	Actions

There are no Entries.

Maximum number of entries reached.

3: EHCP & SEND Info

In Reciept of an EHCP

Yes

In Assessment Process

Date Current EHCP Finalised

MM slash DD slash YYYY

Primary Need(Required)

Local Authorising (Issuing)

Upload EHCP Document

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, Max. file size: 128 MB, Max. files: 3.

4. Educational History

Most Recent / Secondary School(Required)

Name of School

Date Attended(Required)

MM slash DD slash YYYY

Previous Settings

Name of School/Setting	Dates Attended	Reason for Leaving	Actions

There are no Entries.

Maximum number of entries reached.

Primary School (Key Stage 1/2)(Required)

Name of School

Date Attended(Required)

MM slash DD slash YYYY

Early Years / Nursery (EYFS)(Required)

Name of School

Date Attended(Required)

MM slash DD slash YYYY

Reasons for leaving previous setting (if applicable)(Required)

e.g. Moved area, exclusion, medical needs, needs not being met

5: Medical & Specialist Services

Doctor/GP Name(Required)

Surgery/Address/Tel(Required)

Medical Conditions & Allergies(Required)

Please list any diagnosed conditions, allergies (and reaction type) or regular medication.

Dietary Requirements

e.g. Vegetarian, Gluten Free, Halal...

External Agency Involvement(Required)

Social Care

Early Help

SaLT

CAMHS

YOT/YOS

SpLD Support

Other

If Other, please specify details

6: Permissions

(Required)

I give permission for my child to be photographed/filmed for educational purposes (Assessment evidence).

I give permission for my child to be photographed/filmed for marketing (Website/Brochure).

I give permission for my child to access the internet under supervision, in line with the Acceptable Use Policy.

I give permission for my child to take part in local off-site visits (walking distance).

7: GDPR & Declaration

Signature(Required)

Parent/Carer (Type Name)(Required)

Date Signed(Required)

MM slash DD slash YYYY

(Click to save a copy for your records before submitting)

Pupil Registration Form

Elevated Futures Student Registration

1: Student Details

2: Parent/Carer Details

3: EHCP & SEND Info

4. Educational History

5: Medical & Specialist Services

6: Permissions

7: GDPR & Declaration

Elevated Futures Student Registration

1: Student Details

2: Parent/Carer Details

3: EHCP & SEND Info

4. Educational History

5: Medical & Specialist Services

6: Permissions

7: GDPR & Declaration

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