An independent specialist setting
for students with autism and anxiety

lokrumfields@widerambition.org
01905 349915

Parental Initial Enquiry Form

Preferred means of contact

Where more than one person has parental responsibility, they should both provide consent where possible.

By submitting this form, you agree to the following:

I accept the Admissions Policy and the Data Protection Policy for Lokrum Fields, which I can access on the policies page of this site.

I give consent for personal information relating to me or to the above potential pupil to be processed accordingly.

I understand that if I do not want any personal information to be shared with the third parties listed in the Admissions Policy, I must notify Lokrum Fields in writing at the earliest opportunity.

If my child is over 13 years old, they have given their consent for me to include their personal data in this form.

You can download this form here.