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Online background collation tool for new arrivals - Polish

Please complete the following sections in full:

Fields marked with * are mandatory

Ogólne

Unique Pupil Number (UPN)



Imię i nazwisko *



Płeć *

MaleFemale

Data urodzenia? * *



Które z koleji jest to dziecko w Państwa rodzinie?

12345678910

Gdzie się dziecko urodziło? *
Please choose Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland Former USSR France France (European Territory) French Guyana French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe (French) Guam Guatemala Guinea Guinea Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (French) Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar, Union of (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia (French) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Polynesia (French) Portugal Qatar Reunion (French) Romania Russian Federation Rwanda S. Georgia & S. Sandwich Islands Saint Helena Saint Kitts & Nevis Anguilla Saint Lucia Saint Pierre and Miquelon Saint Tome and Principe Saint Vincent & Grenadines Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda UK Ukraine United Arab Emirates Uruguay US USA Minor Outlying Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe


Czy Państwa dziecko mieszkało w innych krajach? Proszę wypełnić tabelę poniżej

Country 1
Please choose Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland Former USSR France France (European Territory) French Guyana French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe (French) Guam Guatemala Guinea Guinea Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (French) Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar, Union of (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia (French) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Polynesia (French) Portugal Qatar Reunion (French) Romania Russian Federation Rwanda S. Georgia & S. Sandwich Islands Saint Helena Saint Kitts & Nevis Anguilla Saint Lucia Saint Pierre and Miquelon Saint Tome and Principe Saint Vincent & Grenadines Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda UK Ukraine United Arab Emirates Uruguay US USA Minor Outlying Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe

Country 2
Please choose Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland Former USSR France France (European Territory) French Guyana French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe (French) Guam Guatemala Guinea Guinea Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (French) Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar, Union of (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia (French) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Polynesia (French) Portugal Qatar Reunion (French) Romania Russian Federation Rwanda S. Georgia & S. Sandwich Islands Saint Helena Saint Kitts & Nevis Anguilla Saint Lucia Saint Pierre and Miquelon Saint Tome and Principe Saint Vincent & Grenadines Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda UK Ukraine United Arab Emirates Uruguay US USA Minor Outlying Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe

Country 3
Please choose Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland Former USSR France France (European Territory) French Guyana French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe (French) Guam Guatemala Guinea Guinea Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (French) Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar, Union of (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia (French) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Polynesia (French) Portugal Qatar Reunion (French) Romania Russian Federation Rwanda S. Georgia & S. Sandwich Islands Saint Helena Saint Kitts & Nevis Anguilla Saint Lucia Saint Pierre and Miquelon Saint Tome and Principe Saint Vincent & Grenadines Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda UK Ukraine United Arab Emirates Uruguay US USA Minor Outlying Islands Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe


Kiedy dokładnie Państwo/Państwa rodzina przyjechała do Wielkiej Brytanii *



Jakie jest wyznanie Państwa dziecka?
Please choose No specific religion African Traditional & Diasporic Baha'i Buddhist Catholic Chinese traditional religion Christian Hindu Muslim Jain Jewish Rastafarian Shintoist Sikh Zoroastrian


Jeśli inne to proszę określić



Czy rodzina ma status uchodźcy lub szuka azylu

TakNie

Wykształcenie

Ile miało lat Państwa dziecko gdy pierwszy raz poszło do szkoły
Please choose Never been to school 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17



Czy dziecko miało jakieś dłuższe przerwy w edukacji? Jeśli tak, to jak długie?




Czy Państwa dziecko ma jakieś problemy w nauce, o których powinniśmy wiedzieć?




Jakich przedmiotów uczyło się dziecko w kraju ojczystym? – proszę wypełnić tabelę poniżej.

Przedmiot	Tak	Nie	Nie wiem
angielski
matematyka
przyroda
informatyka
geografia
historia
W-F
plastyka
technika
religia/etyka
Inne języki obce

  Jakie znasz języki? – wypełnij tabelę

Język	Mówienie	Czytanie	Pisanie
Please choose Acholi Afar-Saho Afrikaans Albanian Alur Amharic Anyi-Baule Arabic Azeri BSL Baluchi Bambara Bemba Bengali Berber (Tamashek) Bulgarian Burmese Cantonese Chinese Caribbean Creole English Caribbean Creole French Chechen Czech Danish Dinka Dutch Ebira Edo Efik English Estonian Ewe Farsi Finnish French Fula Ga Gaelic Georgian German Greek Guarani Gujarati Hausa Hebrew Hindi Hungarian Iban Icelandic Igbo Ilokano Ishan Italian Itsekiri Japanese Jula Kinyarwanda Kirundi Konkani Korean Krio Kurdish Lango Latvian Lingala Lithuanian Luganda Luo Macedonian Malay Malayalam Mandarin Chinese Mandorin Chinese Mauritian Mende Mongolian Ndebele Nepali Norwegian Nyanja Panjabi Pashto Polish Portuguese Russian Shona Slovak Somali Spanish Swahili Sylheti Tagalog Turkish Urdu Vietnamese Yoruba
Please choose Acholi Afar-Saho Afrikaans Albanian Alur Amharic Anyi-Baule Arabic Azeri BSL Baluchi Bambara Bemba Bengali Berber (Tamashek) Bulgarian Burmese Cantonese Chinese Caribbean Creole English Caribbean Creole French Chechen Czech Danish Dinka Dutch Ebira Edo Efik English Estonian Ewe Farsi Finnish French Fula Ga Gaelic Georgian German Greek Guarani Gujarati Hausa Hebrew Hindi Hungarian Iban Icelandic Igbo Ilokano Ishan Italian Itsekiri Japanese Jula Kinyarwanda Kirundi Konkani Korean Krio Kurdish Lango Latvian Lingala Lithuanian Luganda Luo Macedonian Malay Malayalam Mandarin Chinese Mandorin Chinese Mauritian Mende Mongolian Ndebele Nepali Norwegian Nyanja Panjabi Pashto Polish Portuguese Russian Shona Slovak Somali Spanish Swahili Sylheti Tagalog Turkish Urdu Vietnamese Yoruba
Please choose Acholi Afar-Saho Afrikaans Albanian Alur Amharic Anyi-Baule Arabic Azeri BSL Baluchi Bambara Bemba Bengali Berber (Tamashek) Bulgarian Burmese Cantonese Chinese Caribbean Creole English Caribbean Creole French Chechen Czech Danish Dinka Dutch Ebira Edo Efik English Estonian Ewe Farsi Finnish French Fula Ga Gaelic Georgian German Greek Guarani Gujarati Hausa Hebrew Hindi Hungarian Iban Icelandic Igbo Ilokano Ishan Italian Itsekiri Japanese Jula Kinyarwanda Kirundi Konkani Korean Krio Kurdish Lango Latvian Lingala Lithuanian Luganda Luo Macedonian Malay Malayalam Mandarin Chinese Mandorin Chinese Mauritian Mende Mongolian Ndebele Nepali Norwegian Nyanja Panjabi Pashto Polish Portuguese Russian Shona Slovak Somali Spanish Swahili Sylheti Tagalog Turkish Urdu Vietnamese Yoruba
Please choose Acholi Afar-Saho Afrikaans Albanian Alur Amharic Anyi-Baule Arabic Azeri BSL Baluchi Bambara Bemba Bengali Berber (Tamashek) Bulgarian Burmese Cantonese Chinese Caribbean Creole English Caribbean Creole French Chechen Czech Danish Dinka Dutch Ebira Edo Efik English Estonian Ewe Farsi Finnish French Fula Ga Gaelic Georgian German Greek Guarani Gujarati Hausa Hebrew Hindi Hungarian Iban Icelandic Igbo Ilokano Ishan Italian Itsekiri Japanese Jula Kinyarwanda Kirundi Konkani Korean Krio Kurdish Lango Latvian Lingala Lithuanian Luganda Luo Macedonian Malay Malayalam Mandarin Chinese Mandorin Chinese Mauritian Mende Mongolian Ndebele Nepali Norwegian Nyanja Panjabi Pashto Polish Portuguese Russian Shona Slovak Somali Spanish Swahili Sylheti Tagalog Turkish Urdu Vietnamese Yoruba
Please choose Acholi Afar-Saho Afrikaans Albanian Alur Amharic Anyi-Baule Arabic Azeri BSL Baluchi Bambara Bemba Bengali Berber (Tamashek) Bulgarian Burmese Cantonese Chinese Caribbean Creole English Caribbean Creole French Chechen Czech Danish Dinka Dutch Ebira Edo Efik English Estonian Ewe Farsi Finnish French Fula Ga Gaelic Georgian German Greek Guarani Gujarati Hausa Hebrew Hindi Hungarian Iban Icelandic Igbo Ilokano Ishan Italian Itsekiri Japanese Jula Kinyarwanda Kirundi Konkani Korean Krio Kurdish Lango Latvian Lingala Lithuanian Luganda Luo Macedonian Malay Malayalam Mandarin Chinese Mandorin Chinese Mauritian Mende Mongolian Ndebele Nepali Norwegian Nyanja Panjabi Pashto Polish Portuguese Russian Shona Slovak Somali Spanish Swahili Sylheti Tagalog Turkish Urdu Vietnamese Yoruba

Jak dobrze według Państwa dziecko mówi po angielsku?

Dobrze
Trochę
Wcale


Jaki dobrze według Państwa dziecko czyta po angielsku?
Dobrze
Trochę
Wcale


Jak dobrze według Państwa dziecko pisze po angielsku?
Dobrze
Trochę
Wcale


Czy są Państwo zainteresowani kontynuacją nauki języka ojczystego dla Waszego dziecka w weekendy na zajęciach językowych dla lokalnej społeczności?

TakNie

Rodzina

Czy dziecko ma jakieś problemy natury medycznej, o których powinniśmy wiedzieć?
  Nosi okulary
  Przyjmuje leki
  Jeśli inne to proszę określić



Proszę wyszczególnić potrzeby dietetyczne dziecka



Czy uważają Państwo, że będzie potrzebny Państwu tłumacz w kontaktach ze szkołą?

TakNie

Zainteresowania

W czym Wasze dziecko jest dobre?




Czym sie interesuje i jakie ma hobby?

Przyszła edukacja

Jak dalekosiężne cele związane z wykszatałceniem mają Państwo dla Waszego dziecka?
Skończyć szkołę w wieku 17 lat i znaleźć pracę

Dalsza edukacja (np. college)
Wyższe wykształcenie (np. uniwersytet)
Wykonywaniem jakich zawodów jest zainteresowane Wasze dziecko po skończeniu edukacji?

  I have read and agree to the Terms of use

Translation by Kent CC and audio files by Hampshire Ethnic Minority and Traveller Achievement Service