Christ Church CE Primary School
Admission Policy
Admissions Supplementary Form:
Reference from Church Leader
Name of Child:
Surname _____________________ Christian names _____________________________________
Name of Parent(s)/Guardian(s)
_____________________________________________________________
Address
_______________________________________________________________________________
_______________________________________________________________________________
Post code ____________________________
Telephone ______________________________Mobile__________________________________
Place of Worship one of Parents /Guardians regularly attends:
Name of Place of Worship
_________________________________________________________________
Address
_______________________________________________________________________________
_______________________________________________________________________________
Name of Vicar / Priest / Minister / Church Officer
______________________________________________
Address
_______________________________________________________________________________
_______________________________________________________________________________
Post code ___________________________Telephone ___________________________________
I confirm that the Parent/Guardian (and /or child) named above has attended church, at least
monthly, for the past year.
Signed ________________________________________ Vicar / Priest / Minister / Church Officer
Date _____________________________