Archdiocese of Southwark by Dz3p552O


									                    ST JAMES’ ROMAN CATHOLIC PRIMARY SCHOOL
                             Supplementary Information Form

This form should be completed when applying for a place in St James’ Roman Catholic Primary School in the
Archdiocese of Southwark. Please complete and sign the form below and hand it to your Parish Priest at the church
at which you normally worship. He will add his reference in Part 2.
Supplementary Information Forms must be returned to St James’ School, together with a copy of your child’s
baptismal and birth certificates, no later than 3pm on Tuesday 15 January 2013.
NB. You must also complete and return a Common Application Form (available from schools and/or Local Authorities) to L.B. of

                                     PART 1 (To be completed by all parents or carers)

Surname of child: ___________________________________________________                            Date of birth: ____________________

Christian/forename(s) of child: _________________________________________________________________________________

Date and place of Baptism      : _________________________________________________________________________________

Please give details of siblings who will be attending St James’ at the time of this proposed admission _________________________


Parents’ names:                __________________________________________________________________________________

Parents’ religions/denominations: ______________________________________________________________________________

Home address: ____________________________________________________________ Postcode ________________________

How long have you lived at this address?__________________________________________

Contact numbers:      Home ______________________________ Work ______________________________ Mother/Father/Carer)

E-mail addresses:    __________________________________________________________________________________________

Which Mass you normally attend:         Saturday at     _________________________ (time) or Sunday at ______________________ (time)

Parish in which you live                   _____________________________________________________

Usual place of worship (if different):_____________________________________________________________________

How long have you worshipped there? __________ years

How often do you attend Mass?              weekly              at least once a month            less often

Please add here any other information you may feel is relevant to this application in relation to the school’s admissions policy.
(Continue on a separate sheet if necessary).

I confirm that the information we have given on this form is accurate and truthful:

Signed: _____________________________________________                 Parent/carer            Date: ___________________
                                PART 2 (To be completed by your Catholic priests only)

   A.   For all schools:
        I am satisfied that the child is a baptised Catholic                                       Yes No 

   B.   For schools requiring evidence of practice:

                           PARENT/CARER                                                CHILD

     Are the parents known to you?      Yes   No                Is the child known to you?      Yes  No 

     Regular attendance at Mass                                   Regular attendance at Mass         
     (i.e. weekly)                                                 (i.e. weekly)

     Occasional attendance at Mass                                Occasional attendance at Mass      
     (i.e. at least once a month)                                  (i.e. at least once a month)

     Irregular attendance at Mass                                 Irregular attendance at Mass       
     (i.e. less than once a month)                                 (i.e. less than once a month)

     How long have the parent(s)                                   How long has the child
     attended your church?                    ______               attended your church?              ______

    Priest’s name: _________________________________           Parish _____________________________________

    Address: __________________________________________________________                Tel.:___________________

                                                                                       Parish stamp or seal

    Priest’s signature: _______________________________________

    Date: ________________________

If you have lived in the Parish for less than six months please provide a concurrent, supporting reference
from your previous Parish Priest.

  N.B. Please read our attached admissions policy. This has been updated
  since the publication of the “Starting Primary School in Bromley” booklet
 (containing the Common Application Form), and is the policy which will be
  used by the Governors when allocating places for our Reception 2013/14

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