Completion instructions: Parents should fill in this form only if they are applying for a foundation place. The completed form should be returned direct to the school. Failure to return this form will result in any application being considered under the open place criteria.

You should ensure that you have a copy of the admission policy prior to completing the form and returning it to the school no later than 12 noon on Friday 14th February 2014. You must also complete the Common Application Form available from your home Local Authority and name this school on that form. The Common Application Form should be returned direct to your Local Authority.

NB: Parents should only complete this form if they are applying for a Foundation.

1         Pupil Information:
Surname of child:                                                          Other Name(s):

Date of birth:

2         Parent/Guardian Information
Name of parent(s)/guardian(s):


Home address:


Post Code:


Home telephone:                                                  Daytime telephone (if different):

3          Church Commitment
Name of church which you attend:


If this is not an Anglican Church please state the denomination to which your church belongs:





Do you attend church worship at least fortnightly?       Yes                        No 





Have you worshipped in this church for at least two years prior to application?  Yes           No 



If you have worshipped for less than two years at your current church please supply the name and address of your previous church and minister below, in addition to your current minister overleaf.





4          Church Information

Name of Priest/Minister:


Address of Priest/Minister:




Post Code:


I confirm that the information given above is correct and that I have read the admission policy.


Signed:                                                                                             Date:


Please do not complete the Minister’s section below; your minister should complete the following section to verify the information given in paragraphs 3 and 4 above.
5         For Minister’s reference only:
Can you confirm that the applicant is a committed member of your church in the terms of our admission policy, ie, that they have attended worship at least fortnightly for the last two years?   Yes/No

Are there any particular circumstances that the governors should take into account, eg, if church attendance has been less than fortnightly because the applicant is looking after an elderly relative, or for some other valid reason, please give brief details below.





Is your church a member of a local Churches Together Group, Churches Together in England or The Evangelical Alliance? Please specify.


Please supply Registration No:


NB: If a family is refused a place at the school and appeals against the governors’ decision, this form may be used as evidence at the appeal.


Signed:                                                                                             Date: