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School In Year Admissions

Form 2

Parent or carer details

Are you UK service personnel or Crown servant?
Upload
Browse and upload file
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<h1 class="heading-large">Parent or carer details</h1>

<form action="form_3" method="post">
<div class="content-block">

    <div class="form-group">
        <label for="first-name">
            <span class="form-label-bold">First name</span>
        </label>
        <input class="form-control" id="first-name" type="text" name="parent-carer-first-name">
    </div>

    <div class="form-group">
        <label for="last-name">
            <span class="form-label-bold">Last name</span>
        </label>
        <input class="form-control" id="last-name" type="text" name="parent-carer-last-name">
    </div>

    <div class="form-group">
        <label class="form-label-bold">Relationship to the child</label>

        <label class="block-label" for="relationship-mother">
            <input id="relationship-mother" type="radio" name="relationship" value="Mother">
            Mother
        </label>

        <label class="block-label" for="relationship-father">
            <input id="relationship-father" type="radio" name="relationship" value="Father">
            Father
        </label>

        <label class="block-label" for="relationship-carer">
            <input id="relationship-carer" type="radio" name="relationship" value="Carer">
            Carer
        </label>

        <label class="block-label" for="relationship-social-worker">
            <input id="relationship-social-worker" type="radio" name="relationship" value="Social Worker">
            Social Worker
        </label>
    </div>

    <div class="form-group">
        <label for="phone">
            <span class="form-label-bold">Phone</span>
        </label>
        <input class="form-control" id="phone" type="text" name="phone">
    </div>

    <div class="form-group">
        <label for="mobile">
            <span class="form-label-bold">Mobile</span>
        </label>
        <input class="form-control" id="mobile" type="text" name="mobile">
    </div>

    <div class="form-group">
       <label for="email">
            <span class="form-label-bold">Email address</span>
            <!-- <span class="form-hint">We'll only use this to contact you about this application</span> -->
        </label>
        <input class="form-control" type="text" id="email" name="email">
    </div>

     <div class="form-group">
        <label for="email2">
            <span class="form-label-bold">Retype email address</span>
        </label>
        <input class="form-control" type="text" id="email2" name="email2">
    </div>

    <!-- <fieldset class="postcode-search">
        <div class="form-group">
            <label class="form-label-bold" for="postcode">Postcode</label>
            <input class="form-control half-width" id="postcode" type="text" data-postcode-search="search_term">

            <div class="js-hidden" data-postcode-search="results">
                <span class="form-hint">Choose your address below.</span>

                <div class="form-select">
                    <select class="form-select" name="postcode" id="postcode"></select>
                    <span class="arrow"></span>
                </div>

                <input type="hidden" name="result-saontext" data-result="saontext">
                <input type="hidden" name="result-paontext" data-result="paontext">
                <input type="hidden" name="result-paonrange" data-result="paonrange">
                <input type="hidden" name="result-streetname" data-result="streetname">
                <input type="hidden" name="result-locality" data-result="locality">
                <input type="hidden" name="result-town" data-result="town">
                <input type="hidden" name="result-county" data-result="county">
                <input type="hidden" name="result-postcode" data-result="postcode">
                <input type="hidden" name="result-uprn" data-result="uprn">

                <p class="form-block">
                    <button class="text-button" data-postcode-search="change">Change</button>
                </p>
            </div>

            <div class="js-hidden" data-postcode-search="fallback">
                <p class="indent-error-message">Please type your address below.</p>

                <div class="form-group">
                    <label for="building-and-street" class="form-label-bold">Building and street</label>
                    <input type="text" class="form-control" id="building-and-street" name="building-and-street" data-address="building-and-street">
                </div>

                <div class="form-group">
                    <label for="town-or-city" class="form-label-bold">Town or city</label>
                    <input type="text" class="form-control" id="town-or-city" name="town-or-city" data-address="town-or-city">
                </div>

                <div class="form-group">
                    <label for="county" class="form-label-bold">County <span class="unbold">(optional)</span></label>
                    <input type="text" class="form-control" id="county" name="county" data-address="county">
                </div>

                <div class="form-group">
                    <label for="postcode" class="form-label-bold">Postcode</label>
                    <input type="text" class="form-control" id="postcode" name="postcode" data-address="postcode">
                </div>
            </div>
        </div>

        <div class="form-group" data-postcode-search="button">
            <button class="button">Search for address</button>
        </div>
    </fieldset> -->

    <fieldset class="inline">
        <legend>
            <span class="form-label-bold">
                Are you UK service personnel or Crown servant?
            </span>
        </legend>

        <div class="form-group form-group-compound">
            <label class="block-label" data-target="personnel-or-crown-fields" for="personnel-or-crown-yes">
                <input id="personnel-or-crown-yes" type="radio" name="personnel-or-crown" value="Yes">
                Yes
            </label>

            <label class="block-label" for="personnel-or-crown-no">
                <input id="personnel-or-crown-no" type="radio" name="personnel-or-crown" value="No">
                No
            </label>
        </div>

        <div class="panel-indent js-hidden" id="personnel-or-crown-fields">
            <legend>
                <span class="form-label-bold">
                    Upload
                </span>
            </legend>
            <div class="form-group">
                <label for="upload-copy-of-posting">
                    <span class="form-label">We need proof of your posting, for example a copy of your posting order. If you are moving to Medway for a post this should include the date you start and your future address. Uploading it now will help speed up your application or you can send it to us separately by:<br><br>
                    Email to <a href="mailto:admissions@medway.gov.uk">admissions@medway.gov.uk</a><br><br>Post to Student Services, Medway Council, Gun Wharf, Dock Road, Chatham ME4 4TR</span>
                </label>
            </div>
            <div class="form-group">
                <div class="form-upload-button">
                    <span class="button">Browse and upload file</span>
                    <input type="file">
                    <span class="file-name"></span>
                </div>
            </div>
        </div>
    </fieldset>

    <!-- <fieldset class="inline">
        <legend>
            <span class="form-label-bold">
                Are you moving to a location in Medway?
            </span>
        </legend>

        <div class="form-group form-group-compound">
            <label class="block-label" data-target="moveing-to-medway-fields" for="moveing-to-medway-yes">
                <input id="moveing-to-medway-yes" type="radio" name="moving-to-medway" value="Yes">
                Yes
            </label>

            <label class="block-label" for="moveing-to-medway-no">
                <input id="moveing-to-medway-no" type="radio" name="moving-to-medway" value="No">
                No
            </label>
        </div>

        <div class="panel-indent js-hidden" id="moveing-to-medway-fields">
            <div class="form-group">
                <fieldset>
                    <legend>
                        <span class="form-label-bold">
                            Date of move
                        </span>
                    </legend>

                    <div class="form-date form-group form-date-group" data-grouped-inputs>

                        <span class="field-validation-error" data-valmsg-for="DatdOfMove.Day" data-valmsg-replace="true"></span>
                        <span class="field-validation-error" data-valmsg-for="DatdOfMove.Month" data-valmsg-replace="true"></span>
                        <span class="field-validation-error" data-valmsg-for="DatdOfMove.Year" data-valmsg-replace="true"></span>

                        <span class="form-hint">For example, 31 03 1980</span>
                        <div class="form-group-day" data-grouped-input>
                            <label for="DatdOfMove.Day">Day</label>
                            <input maxlength="2" class="form-control" data-val="true" data-val-number="The field Day must be a number." data-val-range="Day must be between 1 and 31." data-val-range-max="31" data-val-range-min="1" data-val-required="Day field is required" id="DateOfMove_Day" name="DatdOfMove.Day" type="text" pattern="[0-9]*" inputmode="numeric">
                        </div>

                        <div class="form-group-month" data-grouped-input>
                            <label for="DatdOfMove.Month">Month</label>
                            <input maxlength="2" class="form-control" data-val="true" data-val-number="The field Month must be a number." data-val-range="Month must be between 1 and 12." data-val-range-max="12" data-val-range-min="1" data-val-required="Month field is required" id="DateOfMove_Month" name="DatdOfMove.Month" type="text" pattern="[0-9]*" inputmode="numeric">
                        </div>

                        <div class="form-group-year" data-grouped-input>
                            <label for="DatdOfMove.Year">Year</label>
                            <input maxlength="4" class="form-control" data-val="true" data-val-number="The field Year must be a number." data-val-range="Day must be between 1980 and 2014." data-val-range-max="2014" data-val-range-min="1980" data-val-required="Year field is required" id="DateOfMove_Year" name="DatdOfMove.Year" type="text" pattern="[0-9]*" inputmode="numeric">
                        </div>

                    </div>
                </fieldset>

            </div>

            <fieldset class="postcode-search">
                <div class="form-group">
                    <label for="postcode">
                        <span class="form-label-bold">New Postcode</span>
                    </label>
                    <input class="form-control half-width" id="postcode" type="text" data-postcode-search="search_term">

                    <p class="postcode-term-change js-hidden" data-postcode-search="postcode_term_change">
                        <b data-postcode-search="postcode_term"></b>
                        <button class="text-button" data-postcode-search="change">Change</button>
                    </p>

                    <span class="field-validation-error" data-valmsg-for="postcode" data-valmsg-replace="true"></span>

                    <div class="js-hidden" data-postcode-search="results">

                        <div class="form-select">
                            <select class="form-select" name="postcode" id="postcode" data-val="true" data-val-required="Select an address from the drop down menu"></select>
                            <span class="arrow"></span>
                        </div>

                        <input type="hidden" name="result-saontext" data-result="saontext">
                        <input type="hidden" name="result-paontext" data-result="paontext">
                        <input type="hidden" name="result-paonrange" data-result="paonrange">
                        <input type="hidden" name="result-streetname" data-result="streetname">
                        <input type="hidden" name="result-locality" data-result="locality">
                        <input type="hidden" name="result-town" data-result="town">
                        <input type="hidden" name="result-county" data-result="county">
                        <input type="hidden" name="result-postcode" data-result="postcode">
                        <input type="hidden" name="result-uprn" data-result="uprn">
                    </div>

                    <div class="js-hidden" data-postcode-search="fallback">
                        <p class="indent-error-message">Please type your address below.</p>

                        <div class="form-group">
                            <label for="building-and-street" class="form-label-bold">Building and street</label>
                            <input type="text" class="form-control" id="building-and-street" name="building-and-street" data-address="building-and-street">
                            <input class="form-control" data-address="address2" id="building-and-street2" name="building-and-street2" type="text" value="" />
                        </div>

                        <div class="form-group">
                            <label for="town-or-city" class="form-label-bold">Town or city</label>
                            <input type="text" class="form-control" id="town-or-city" name="town-or-city" data-address="town-or-city">
                        </div>

                        <div class="form-group">
                            <label for="county" class="form-label-bold">County <span class="unbold">(optional)</span></label>
                            <input type="text" class="form-control" id="county" name="county" data-address="county">
                        </div>

                        <div class="form-group">
                            <label for="postcode" class="form-label-bold">Postcode</label>
                            <input type="text" class="form-control" id="postcode" name="postcode" data-address="postcode">
                        </div>
                    </div>
                </div>

                <div class="form-group" data-postcode-search="button">
                    <button class="button">Search for address</button>
                </div>
            </fieldset>

            <div class="file-upload">
                <label for="upload-tenancy-agreement">
                    <span class="form-label-bold">Upload a copy of your new tenancy agreement or proof of exchange</span>
                </label>
                <div class="form-group" data-file-upload="button">
                    <div class="form-upload-button">
                        <span class="button">Browse and upload a file</span>
                        <input type="file">
                        <span class="file-name"></span>
                    </div>
                </div>
            </div>

        </div>
    </fieldset> -->

    <div class="form-step-buttons">
        <a href="form_1" class="button">Previous</a>
        <button type="submit" class="button">Continue</button>
    </div>

</div>
</form>