Diocese of Westminster

St Gregory’s Catholic Primary School (Ealing)

Supplementary Information Form 2018 – 2019

The closing date for applications for entry in September 2018 is: 15 January 2018

Late applications will be subject to the same criteria as applications received before the closing date but will only be considered after applications received on or prior to the above closing date.

Child’s Details

Child’s First Name(s):
Child’s surname: / Date of Birth:
Home Address:
Two proofs of residence will be required / Postcode:

Parent/Carer Details

Parent(s)/Carer(s) name:
Address:
Telephone Number(s):
Email Address:

Details of Religion

Religion of child:
(Please tick) / Catholic / Other Christian(Name of denomination e.g. Methodist) / Other faith
Catholic Parish you live in:
Church where child was baptised and date of baptism: (baptism certificate required)
Name and position of priest supplying Certificate of Catholic Practice or religious leader providing letter confirming membership of the faith community (where appropriate):
Names of brother and sisters at this school: / Name: Class:
Is your child ‘looked after’ by the Local Authority, adopted or subject to achild arrangements or special guardianship order*? Please circle your response.
*(immediately following being ‘looked after’) / YES NO
Does your child have exceptional medical, pastoral or social needs that can only be met by attendance at this school? Please tick the box below. (Professional evidence will be required at time of application)

YES NO

I confirm that I have read and understood the Admissions Policy and that the information I have provided is correct. I understand that I must notify the school immediately if there is any change to these details and that should any information I have given prove to be inaccurate that the governors may withdraw any offer of a place even if the child has already started school.

Signed…………………………………………...Mother/Father/Legal Guardian

Date…..………………………………………………

Print Name: ……………………………………………………….…………………

Please note:
  • Where applicable parents can obtain a Certificate of Catholic Practice Form from the Diocese of Westminster website at your parish priest.
  • Applicants from other Christian denominations and other faiths may attach a letter confirming membership of the faith community from their minister or religious leader.
  • You must complete the Local Authority’s E--Admissions Form at return to the council offices by the closing date. If you do not do this you will not be offered a place.
Checklist:
Have you enclosed: Copy of baptism certificate (where necessary)
Proof of date of Birth
First Proof of residence i.e. current year’s council tax bill
(If you do not pay Council Tax the following may be accepted: Council rent book for the current year, Tenancy Agreement from a private letting agency, letter from Social Services or Housing Department confirming placement at your address, letter from National asylum Support Services (NASS). If you are moving home, a solicitor’s letter confirming the date that contracts were exchanged and the proposed completion date.)
Certificate of Catholic Practice Form (where necessary,see above)
Evidence of exceptional need (where appropriate)
Second proof residence: A utility bill dated within the last six months e.g. Gas, Water,
Electric, Home landline bill, in your name.
Have you completed the E-Admissions Form and returned it to Admissions at
Ealing Council, Perceval House, 14/16 Uxbridge Road, W5 2HL or your First choice school.
*Incomplete or late applications will only be considered after all fully completed applications received by the closing date as stated overleaf.