Leaver Information Form

When a child leaves Heathside, we must report the move to the Local Authority and share contact details for their parents, and details of their new school or Nursery.

"*" indicates required fields

Step 1 of 3

Child's Details

Child's Name*

First Last

Child's Date of Birth*

Child's Current Year Group*

Gender*

Reason for leaving*

Parent / Carer Contact Information

We are required by the Local Authority to provide an up to date name, phone number and address for the child's primary parent or carer whom they will be living with. If you are moving abroad, where possible, please provide the address of where your family will be living when you have left the UK and a phone number you will be reachable on when you are abroad.

Primary Parent / Carer Name*

First Last

Contact Number*

Address of whom the pupil will be living with*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Leaver Information

Last day at Heathside*

Name of next School or Nursery*

Address of next School or Nursery*

Street Address Address Line 2 City Post Code Country

Contact Email Address for next School or Nursery*

We are required to contact the child's next School or Nursery to confirm their attendance before we remove the child from the roll at Heathside School Hampstead.

First Day at next School or Nursery*