Application Form for Admission To

SUPPLEMENTARY INFORMATION FORM FOR ADMISSION TO

LIMPSFIELD C.E. INFANT SCHOOL (VOLUNTARY AIDED) 2018

“Achieving together in God’s light”
Parents must fill in this form when applying for a place at the school under Criteria 5 or 6 of the school’s Admissions Policy. It should be returned to the school by the date specified on the Surrey form.

Section A: Pupil Information

Surname of child: Other Name(s):
Date of Birth:

Section B: Parent/Guardian Information

Name of parent(s)/guardian(s):
Home address :
Home telephone: Daytime telephone (if different):
Email adddress:

Section C: Church Information

Are you applying for a place under Criteria 5 or 6 of the admission policy? (If you are applying under these criteria, please advise your priest beforehand.)
If yes, please complete the following section.
Name of Church which family attends:
Do you attend church worship on average twice a month?
Have you attended church for at least one year prior to the date of application?
Please supply examples of your commitment to your church/place of worship, (e.g. could be one or more of the following - being on church committees, leading church youth groups, belonging to house groups, participating in home/study, mission and /or worshipgroups, reading in church, singing in the choir, having responsibilities in the church, e.g., steward or sidesperson, working as a Sunday school teacher or leading worship), for at least a year prior to the date of application, rather than merely being occasional worshippers. Please ask your priest, minister or senior member of your church community to complete Section D. If this section is not completed, the minister indicated below will be contacted by the school.
Name of Priest/ Minister:
Phone number of Priest/ Minister:
Email address of Priest/Minister
Address of Priest/ Minister:
NB: If you have moved recently, please give the name & address of your family priest.
Signed: Date:
(Parent/Guardian)

Section D: 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, see Section C
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 elder 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:
(Minister)

J:\Pupils\Admissions\Admissions\2018-19\Admission Policy Supplementary Form 2018.docx