Welcome to Marian Mission Educational and Family Support Centre!

XPage 1 of 1 XXXXXXXXXXXXxXXXXXXXXXContact Details of Parent/Guardian
First Name xx
Title iiiiiiiiiiii (Select one from list)
Last Name xx
Today's Date:
Street Address xx
Your E-mail
Other Address xx
Home Telep
Post Code xx
Mobile Tele
Information about the Pupil you want to register
Child's First Name xx
Gender (Select one from list)
Child's Last Name xx
Any special medical condition? Yes No
Child's Date of Birth xx
Day Month Year
Emergency Telephone Number
Is the child on the Child Protection Register? xxxxxxxxxxxxxxxxxxiixxxxxxii Yes No
Is the child subject to any order under the Child Protection Act? xxxxxxi Yes No
     
Information about your child's education
Subject
Select
Strength
Use the following key to select child strength for each subject
English
W Av G Ex
W = Weak, Av = Average, G= Good, Ex= excellence
Mathematics
W Av G Ex
State any disability in the text box below
Science
W Av G Ex
Geography
W Av G Ex
XXOther
W Av G Ex
XXOther
W Av G Ex
Ethnicity and Equal Opportunity Monitoring
 
Select one of the following best describe your ethnicity
Black Asian White Chines Mixed Chinese Other Others (please state)
 
Home Language
XXXOther Languages
     
Click to tick any of the following that apply to your child
Additional Needs xxx
Intensive Support At risk of disengaging Minimum Intervention
Verbal Aggression xxx
Towards Staff xiii Towards peer
Physical Aggress xxx
Towards Staff iiiiii Towards peer
Reason for referral xxx
Excluded from school regularly iiiiiiiiii At risk of exclusion Regularly truant Known to police
Known to young offenders Team iiiiii Care leaver iiiiiiiiiiiii Drug user iiiiiiiiiii
Which of the following already xxx
Learning mentor i Personal Advisor Social Services i Educational Welfare Officer
work with this young person? xxx
Probation Officer Other Agency
 
Please check your e-mail for for an acknowledgment of your message and related information.
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