Conisborough College Students Outdoors Lewisham

Change of Details Form

Use the form below to provide the school office with updated details for students, parents/carers, medical information and emergency contacts.

Student(s) Affected by Change
Student's Full Name*
First Last
Student's Tutor Group*
Add a second affected Student?*
- Yes
- No
Second Student's Full Name*
First Last
Second Student's Tutor Group*
Add a third affected Student?*
- Yes
- No
Third Student's Full Name*
First Last
Third Student's Tutor Group*
Changed Details
What details have changed?*
- Student's Home Address Change
- Existing Parent/Carer Details Change
- New, Additional or New, Replacement Parent/Carer Details
- Emergency Contact Details Change
- Medical Information Change
- Anything else…
Student's New Home Address*
Street Address Address Line 2 City Post Code Country
Student's Old Home Address*
Street Address Address Line 2 City Post Code Country
Existing Parent/Carer's Full Name*
Prefix First Name Last Name
Relationship to Student(s)*
Has the Existing Parent/Carer's home address changed?*
- Yes
- No
Is the Existing Parent/Carer's new home address the same as the Student's new address??*
- Yes
- No
Existing Parent/Carer's New Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Existing Parent/Carer's Old Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Has the Existing Parent/Carer's email address changed?*
- Yes
- No
Existing Parent/Carer's Old Email Address*
Existing Parent/Carer's New Email Address*
Enter Email Confirm Email
Have the Existing Parent/Carer's phone details changed?*
- Yes
- No
Existing Parent/Carer's New Daytime Phone Number 1*
Existing Parent/Carer's Old Daytime Phone Number 1*
Existing Parent/Carer's New Daytime Phone Number 2
Existing Parent/Carer's Old Daytime Phone Number 2
Are you a New, Additional Parent/Carer to the student(s) or replacing an existing Parent/Carer?*
- New, Additional Parent/Carer
- New, Replacement Parent/Carer
New, Additional Parent/Carer's Full Name*
Prefix First Name Last Name
New, Additional Parent/Carer's Daytime Phone Number 1*
New, Additional Parent/Carer's Daytime Phone Number 2
New, Additional Parent/Carer's Email Address*
Enter Email Confirm Email
New, Additional Parent/Carer's Relationship to Student(s)*
Is the New, Additional Parent/Carer's home address the same as the Student's address??*
- Yes
- No
New, Additional Parent/Carer's Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
New, Replacement Parent/Carer's Full Name*
Prefix First Name Last Name
Full Name of Parent/Carer being replaced*
Prefix First Name Last Name
New, Replacement Parent/Carer's Daytime Phone Number 1*
New, Replacement Parent/Carer's Daytime Phone Number 2*
New, Replacement Parent/Carer's Email Address*
Enter Email Confirm Email
New, Replacement Parent/Carer's Relationship to Student(s)*
Is the New, Replacement Parent/Carer's home address the same as the Student's address??*
- Yes
- No
New, Replacement Parent/Carer's Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you updating or replacing an Existing Emergency Contact?*
- Updating/Editing an Existing Emergency Contact
- Replacing an Existing Emergency Contact
Existing Emergency Contact's Full Name*
Prefix First Name Last Name
Existing Emergency Contact's Relationship to Student(s)*
Has the Existing Emergency Contact's email address changed?*
- Yes
- No
Existing Emergency Contact's Old Email Address*
Existing Emergency Contact's New Email Address*
Enter Email Confirm Email
Have the Existing Emergency Contact's phone details changed?*
- Yes
- No
Existing Emergency Contact's New Daytime Phone Number 1*
Existing Emergency Contact's Old Daytime Phone Number 1*
Existing Emergency Contact's New Daytime Phone Number 2
Existing Emergency Contact's Old Daytime Phone Number 2
New, Replacement Emergency Contact's Full Name*
Prefix First Name Last Name
Full Name of previous Emergency Contact being replaced
Prefix First Name Last Name
New, Replacement Emergency Contact's Relationship to Student(s)*
New, Replacement Emergency Contact's Email Address*
Enter Email Confirm Email
New, Replacement Emergency Contact's Daytime Phone Number 1*
New, Replacement Emergency Contact's Daytime Phone Number 2
Medical Information*
Please provide details of any changes to the student's medical history or status.
Other Information*
Please provide details of any other changes to the student(s), Parent/Carer's or Emergency Contact's situation you feel the school should be aware of.
Declaration & Consent
Full Name of person completing form*
First Last
Email Address of person completing form*
Enter Email Confirm Email
Consent*
I agree to the Conisborough College Website Privacy Policy
I hereby agree to the provision of the above information in order for the school to maintain it's records. I agree to the processing of said information in line with our Data Protection Policy (link - which conforms to the General Data Protection Act, May 2019).
Signature*
Email
This field is for validation purposes and should be left unchanged.

Change of Details Form

Student(s) Affected by Change

Changed Details

Declaration & Consent

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