Blue Coat Church of England School and Music College Supplementary Information Form – Admission from Sep 2017 This form to be completed by the Parents / Guardians of the child seeking admission. If you need help to complete this form for any reason, please contact: Mrs Sarah Moore, Office Manager, Blue Coat School, Terry Road, Coventry, CV1 2BA Tel: 024 7622 3542 or Email:
[email protected] (Please use BLOCK CAPITAL letters throughout) 1. Please provide the following information for contact and administrative purposes:
Last Name (of Child):
______________________________________________________________
First Name(s):
______________________________________________________________
Date of Birth:
____________________________________
Male/Female:
____________________________________
Home Address:
_______________________________________________________________ ___________________________________________________________________ ___________________________________________________________________
Post Code:
____________________________________
2. Please tick to indicate which of the following criteria apply to your application: (Further explanations are provided in the Admissions Policy) 1 CofE
_____
parent and child can demonstrate weekly participation at a CofE Church Please go to Section 3
2 CHRISTIAN
_____
parent and child can demonstrate weekly participation – see Appendix 1 Please go to Section 3
3 OTHER
_____
all other applications Please go to Section 6
Applicants should note that the Governors of Blue Coat School have, after consultation with representatives of the Roman Catholic Church, taken into account the significant number of places at Roman Catholic Secondary Schools in the City.
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3. Please provide the following information about the worshipping community in which your child participates (if none please write ‘none’ and go to section 6): Name of your worshipping community: ________________________________________________________________________
Denomination: ________________________________________________________________________
Name of the Minister/Official: ________________________________________________________________________ (this person to complete the declaration at Section 7)
4. Optionally, please provide the following information about any other worshipping community that either you or your child have attended in the last 12 months (if none please write ‘none’ and go to section 5): (Optional) Name of your additional worshipping community: ________________________________________________________________________
Denomination: ________________________________________________________________________
Name of the Minister/Official: ________________________________________________________________________ (this person to complete the declaration at Section 8)
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5. Please tick below to indicate the level of the active participation of your family in the life of your worshipping community in terms of attendance for public acts of worship, religious instruction or Sunday School over the last 12 months: a) Child
_____
b) Parent/Guardian _____
the applicant child has attended on at least 35 weeks during the last 12 months the parent / guardian who most regularly attends has attended on at least 35 weeks during the last 12 months
Please Note – only the attendance of the child and one parent / guardian can be considered. The attendance of other family members cannot be included unless they are the legal guardian of the child. Information provided in Section 5 above will be used to rank applications. If this Supplementary Information Form is incorrect or incomplete in any way, Governors may not be able to fully assess your application, and this may result in your application being unsuccessful.
6. Declaration by Parent / Legal Guardian The information given on this application form to apply for a place at Coventry Blue Coat Church of England School and Music College is true and I understand that any place offered will be withdrawn if the information given is found to be fraudulent or intentionally misleading. The Local Authority / Governors will check the information provided to prevent and detect fraud.
Name: ________________________________________________ (BLOCK CAPITALS) Signed:
________________________________________________
Date:
______________________________
Home Phone:
______________________________
Mobile:
______________________________
Please also ensure that the supporting declaration(s) in Sections 7 (and 8) are completed.
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7. Declaration by Minister / Official / Representative (from Section 3) I fully and unreservedly support this application for the named child to attend Coventry Blue Coat Church of England School and Music College. I have discussed the information given on this application form with the parent / guardian and to the best of my knowledge and belief, it is true and accurate. Please tick to confirm that the following statements are true:
_________
I confirm that the faith organisation that I represent is either a member of Church of England, or is one of the churches listed in Appendix 1 to this form.
_________
I confirm that I am a recognised minister (or hold a similar position) in the faith organisation that I represent, and that the applicant child and parent /guardian are personally known to me.
Name: ________________________________________________ (BLOCK CAPITALS) Position Held:
________________________________________________
Signed:
________________________________________________
Date:
______________________________
Contact Address:
________________________________________________ ________________________________________________ ________________________________________________
Contact Phone:
______________________________
Mobile:
______________________________
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8. OPTIONAL Declaration by Second Minister / Official (from Section 4) I fully and unreservedly support this application for the named child to attend Coventry Blue Coat Church of England School. I have discussed the information given on this application form with the parent / guardian and to the best of my knowledge and belief, it is true and accurate. Please Tick to confirm that the following statements are true:
_________
I confirm that the faith organisation that I represent is either a member of Church of England, or is one of the churches listed in Appendix 1 to this form.
_________
I confirm that I am a recognised minister (or hold a similar position) in the faith organisation that I represent, and that the applicant child and parent /guardian are personally known to me.
Name: ________________________________________________ (BLOCK CAPITIALS) Position Held:
________________________________________________
Signed:
________________________________________________
Date:
______________________________
Contact Address:
________________________________________________ ________________________________________________ ________________________________________________
Contact Phone:
______________________________
Mobile:
______________________________
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9. What the applicant MUST do now Please ensure that this form is fully completed, and that the declarations are completed as required. If you need any further information or require assistance to complete this form, please contact the Admissions Team at Blue Coat School in the first instance: Telephone: Email:
024 7622 3542 (1)
[email protected]
(2)
[email protected]
You must return this completed Supplementary Information Form (before any closing date) to: Mrs S Moore, Blue Coat School, Terry Road, Coventry, CV1 2BA. When the form is received at the school it will be stamped with the date received.
If you intend to post the form or return it via your Local Authority it is suggested that you should keep a copy for your records and also obtain a receipt or proof of posting.
Please Note – Your application will only be considered if you have also completed the Common Application Form required by your Local Authority.
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Appendix 1 The Governors of Coventry Blue Coat Church of England School and Music College recognise the following as being the definition of “Another Christian Worshipping Community”: 1
Churches that are full members of the following National Organisations:
Baptist Union of Great Britain Cherubim & Seraphim Council of Churches Church of Scotland Congregational Federation Council of African and Afro-Caribbean Churches Evangelical Alliance Greek Orthodox Church International Ministerial Council of Great Britain Joint Council of Afro-Caribbean Churches Methodist Church
2
Moravian Church New Testament Assembly Religious Society of Friends (Quakers) Russian Orthodox Church Salvation Army UK Territory Serbian Orthodox Church Seventh Day Adventist Church United Reformed Church Wesleyan Holiness Church
Local Churches (whether or not included in the list of National Organisations):
Abundant Faith Centre Agape Church Aldermans Green Free Methodist All Nations Church Apostolic Faith Mission Asian Outreach Punjabi Church Assemblies of God Bell Green Life Centre (New Testament Church of God) Bell Green New Life Church (also known as Northpoint Church Centre) Balm in Gilead Ministries Berachah Faith Ministries Bethel Evangelical Church Bethesda Chapel Bilton Evangelical Church Bretheren in Christ Church Canley Evangelical Church Christ Embassy Christian Life Ministries Church of God Prophecy Church of Pentecost, Birmingham Church Street Gospel Hall Cornerstone Church of God, Hillfields Coundon Fellowship Coventry Asian Fellowship Coventry Chinese Church Coventry Christian Fellowship Coventry Church, Ansty Deeper Life Bible Church Durbar Avenue Evangelical Church El Shaddai International Centre Elim Pentecostal Church Emmanuel Church Faith International Ministry Father's Heart Chapel Forward in Faith Ministries - Hillfields Good Shepherd Lutherian Church Heartbeat Centre
Hebron Christian Centre Hillfields Christian Fellowship Immanuel Church, Greens Road International Ministries for the Living Word Jesus Fellowship Jireh Baptist Church Jubilee Church King’s Chapel Apostolic Church King’s Church Kingshurst Evangelical Church Lawrence Saunders Road Baptist Church Lee Church, Lapworth Libyan School, Barr's Hill Living Rock Church Living Word Temple, Tottenham Lower Ford Street Baptist Church Manor Court Baptist Church, Nuneaton Miracle Life Gospel Church Mosaic Church Mount Zion Pentecostal Need of our Nation Christian Fellowship New Horizons New Life Christian Fellowship Nuneaton Christian Fellowship Queen’s Road Baptist Church Presence of God Ministries (Touching Nations) Redeemed Christian Church of God Restoration Christian Ministries Saltisford Evangelical Church Seventh Day Adventists Solihull Christian Renewal Centre Streams of Life Vineyard Church Weslyan Reform Union, Bedworth Word of Life Willenhall Free Church
Page 7 Hillfields Evangelical Church House of Empowerment
