Statement of interest in joining the Periplus Free School

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Completion of this form does not formally commit you to applying for, or accepting, a place at the proposed state funded Internet school. However it will be taken as evidence of your genuine interest in the proposal. If you require any further information before completing this questionnaire please contact Periplus at info@periplus.org.uk or call us on 0207 843 5891.

The forms will remain confidential to Periplus and those compiling the application for the school. No individual form will be submitted to the DfES or used in any way, other than to support the named child at the time of enrolment if the application is successful. If the application is unsuccessful, all forms will be destroyed unless we are given permission to resubmit the application for a 2013 start. The questions are all intended to provide evidence to build the case for the school.

5. Gender of Child *This question is required.
9. Was a Local Education Authority or School Notified of the decision to home educate? (there is no requirement to answer this question)
Information provided in response to the following questions is totally confidential and will NOT be used as part of the selection criteria for admission. It's sole purpose is to provide, without any reference to any individual, evidence to ensure the proposal, as submitted, will enable us to meet the needs of those likely to be admitted).
13. Have you ever been advised by a school that your child is on the special needs code of practice or has a statement of additional need? *This question is required.
15. If your child was attending a state school at present do you know /believe that you would qualify for free school meals based on income/benefit criteria *This question is required.
N.B. If the application for the school is successful, and you would like your child to be enrolled, it will be necessary to prove residency and a right to education in the UK
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