Date of Birth:
Please Select -->
Male / Female:
Parent / Carer Name:
If you are moving house please tell us your new address:
Date of move:
Once we have allocated a place at a school, your child must start within four school weeks.
If they do not you will have to re-apply. Please bear this in mind if you are in the process of moving house.
Does your child have a statement of special educational needs?
Is your child looked after?
If Yes, which local authority:
Name of social worker:
Was your child previously looked after?
If yes, you will need to provide evidence to support this.
Please submit the evidence to the contact details at the bottom of the form.
Please select the evidence you will be providing
Adoption OrderResidence OrderSpecial Guardianship Order
Is your relocation due to a new posting?
Date of new posting:
If yes, you will need to provide a letter from your commanding officer to confirm this. Please send this to the contact details at the bottom of the form.
Date last attended:
Has your child ever been permanently excluded?
If yes, please give date(s):
Reason(s) for requesting a change of school:
Can this information be shared with you child's current school:
It is essential that my children attend the same school
NOTE: If you tick the box, we will offer you the highest preference school where all of your children can be
admitted. If none of your preferences can offer all of your children a place, we will try to offer another school
with places for all. If you do not tick the box we will offer places according to your preferences which may
mean your children have to attend different schools.
Reason for preference:
If you have a sibling at this school / applying for this school, please give details:
This information falls within the Data Protection Act. The information supplied will be held on computer
for the purposes of education and training administration and will be used solely for this purpose and
disclosed when necessary to the Local Authority, Schools, School Inspector’s etc. The information on
this form and ay other information subsequently provided whether by meeting, phone, fax, email or letter
would also be used for this purpose. I freely consent to the use of the personal data as described in this
I confirm that I have Parental Responsibility and/or care of the child, and that the child lives with me.
My relationship to the child is:
Name of applicant:
Address: School Organisation Team, Wigan Council, Progress House, Wigan, WN3 4HH
Telephone: 01942 486037 or 01942 486039
© Wigan Council