West Sussex Admission Form

In-Year – Primary Age Application

Please complete all boxes and hand this form to your preferred school. Child’s Details
Child’s legal
last name:
Child’s
first names:
Male/Female: Date of birth: Age: Current Year Group:
Child’s application address:

Proof of
Address Required (See leaflet)
Date of move
or proposed date:
Previous address:
Preferred Schools
Name of Preferred School Reason for Preference
1
2
Requested date of admission:
Are there any siblings currently
attending the preferred school?
Yes No
If yes please list their name(s), date of
birth and home address below:
Name Date of Birth Address
Does your child have a statement of
educational need?
Yes No
Looked After Children (please complete thissection if the child is in Public Care)

Parent/Carer’s Details

I confirm that the details given above are correct.

I understand that the Authority reserves the right to verify any of the information given on this
form and that any offer of a school place will be on the basis that the information supplied is accurate and current.
A school place may be subsequently withdrawn if the information supplied is found to be false. All information
will be stored according to the Data Protection Act.

Signature of Parent/Carer or Local Authority for Looked After Child

_________________________________________________Date______________________________

For School Office Use Only

  Preferred School 1
School Name
Preferred School 2
School Name
Date application received    
Proof of Age    
Proof of address    
Proof of Statement of Special Educational
Need
   
Offer Letter (Out of Area)    
No Space Letter    
Date of Admission    
Date form sent to LA    

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Contact Details

Medmerry Primary School,
High Street,
Selsey,
West Sussex.
PO20 OQJ
Tel: 01243 602 738
Fax: 01243 605 274