Pre-Arrival Data

STUDENT DETAILS

Legal Names (as shown on birth certificate & passport) *

First

Middle

Last

Preferred Names *

First

Last

Gender *

Male
Female

Date of Birth *//

Country of Birth *

Nationality *

Home Language *

First Language *

Religion

Ethnicity *

Address (in home country) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Telephone *

Student Email Address *

PARENT DETAILS

Please give details of all persons who have parental responsibility.

Primary Contact Parent / Guardian *

First

Last

Relationship *

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Telephone *

Mobile Telephone

Work Telephone

Email Address *

Second Contact Parent / Guardian *

First

Last

Relationship *

Home Address (copy) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home Telephone *

Mobile Telephone

Work Telephone

Email Address *

EMERGENCY CONTACT

Please add details of someone who can be contacted in the event of an emergency. **Please provide different contact details from parents if available.**

Emergency Contact *

First

Last

Relationship (if any) *

Emergency Telephone *

DIETARY NEEDS / PREFERENCES

Please select dietary requirements from the following list: *

Please provide any other relevant information.

CURRENT MEDICAL CENTRE

Please provide the name and contact details of the current Medical Practice of the student.

Medical Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Medical Phone

AGREEMENT

Name of person completing this Data Collection Form *

First

Last

Relationship to student (NB This should be someone with parental responsibility or an Agent) *

GDPR Agreement *

I consent to this website storing this information so that the Admissions Team can enrol this student.

The data being collected, controlled and processed is in line with General Data Protection Regulations (GDPR). The school has a duty to protect this data and to keep it up to date. The school is required to share some of the data with the Education Authority and with the Department of Education.

STUDENT DETAILS

PARENT DETAILS

EMERGENCY CONTACT

DIETARY NEEDS / PREFERENCES

CURRENT MEDICAL CENTRE

AGREEMENT

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