St. Thomas Moorside C.E. (V.A.) Primary School
Coleridge Road, Sholver, Oldham, OL1 4RL
Tel: 0161 624 9290 Fax: 0161 620 4706
Supplementary Form 1
in Support of Application for Admission
APPLICATION TO (Please tick one):
NURSERY
RECEPTION
OTHER YEAR GROUP
APPLICATION FOR ADMISSION 201…. (Please indicate year)
PLEASE NOTE: You cannot apply for both nursery and reception classes on the same
form. Parents of nursery pupils are required to complete a second form next year to
apply for a place in reception class
If you require assistance or advice about the completion of this form, please do not hesitate to
contact the School Office on 0161 624 9290.
1. Child’s Details
Forename(s) ...................…………............ Surname ............…………......…………….........
Date of Birth ...........….............. Boy…... Girl…...
Full Home Address …...........................................................................................................
…………………………………………………………………Tel; ………………………………..
2. Parent(s)/Guardian(s) Details
Name of Parent/Guardian 1 ……....................………….........................................................
Address (if different from child) ..............................................................................................
……………………………………………………………….Tel: ………………………….………..
Name of Others with Legal Parental Responsibility ...................................….......................
Address (if different from child) …..........................................................................................
…………………………………………….…………….…....Tel: ……………….…………………
3. Brothers & Sisters in St. Thomas’ School
Please give details of any brothers or sisters of this child who will also be attending St.
Thomas’ Moorside School in the year you wish your child to start school.
Name
Date of Birth
(Delete as applicable) Is this child a;
1............................ .........................
Full/Half/Step/Adopted or Foster brother/sister
2............................ ..........................
Full/Half/Step/Adopted or Foster brother/sister
5.
Special Circumstances.
If there are any other special reasons why you feel your child should be admitted to St.
Thomas’ Moorside school, which you wish to be taken into consideration, e.g. identified
medical needs or special educational needs, please fill in the section below, attaching
separate sheets if necessary, and submit any supporting documentation with this form.
Where admission is sought under special medical or social circumstances criteria,
professional supporting evidence, e.g. from a doctor, psychologist or social worker, is
essential. Such evidence must set out the particular reasons why the school is the most
suitable for the child and the difficulties that would be caused if the child had to attend another
school. This supporting evidence must be submitted to school along with this supplementary
form.
Special Circumstances………………………………………………………………………….
Supporting documentation attached
6.
Yes/No
Church Attendance
Parents who wish attendance at church to be considered when applying for a place must also
complete the school’s supplementary form 2 Please complete supplementary form 2 and
return it with this form. If you do not attend church, you do not need to return form 2. If you do
not complete form 2, your child cannot be considered for a place on the basis of faith but will
be considered under all relevant non-faith criteria.
Religion/Denomination……………….……….Place of worship attended………….…………..
Signed
......................…..............................................
Relationship(s) to Child
...........................................….........................
Date: ...........................……………................
PLEASE INCLUDE ANY SUPPLEMENTARY FORMS OR INFORMATION REGARDING
CHURCH ATTENDANCE OR SPECIAL CIRCUMSTANCES
Note
School may take steps to check the information given on this form. If false or
misleading information is given, such as a false date of birth, false address, or one
where the child is not actually living when s/he is not at school, this may disqualify the
applicant. Please contact the Headteacher of the school if you have any queries in this
respect.
TO BE RETURNED TO
St. Thomas’ Moorside C.E. (V.A.) Primary School,
Coleridge Road, Sholver, Oldham OL1 4RL
ALL SUPPLEMENTARY FORMS WILL BE ACKNOWLEDGED BY THE SCHOOL WITHIN 7
DAYS. IF YOU DO NOT RECEIVE A RECEIPT FROM SCHOOL, THE SCHOOL HAS NOT
RECEIVED YOUR APPLICATION. IN THIS INSTANCE, YOU MUST CONTACT SCHOOL
IMMEDIATELY ON 0161 624 9290
St. Thomas’ Moorside C.E. (V.A.) Primary School
Admission Application Supplementary form 2
THIS SECTION TO BE COMPLETED BY PARENT/GUARDIAN
Name of child:
Surname . . . . . . . . . . . . . . . . . . . . . Christian names . . . . .. . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth . . . . . . . . . . . . . . . . . . . .
Name of parent/guardian…….. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . .
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Post code . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Place of worship regularly attended by the child and parent /guardian:
Name of place of worship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.......................................................................
Name of vicar / priest / minister………………... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . ………Post code . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Telephone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Regular attendance is a minimum of fortnightly attendance at church at public worship for at
least one year prior to submission of the application. Based on this definition, do you and
your child regularly attend the above church? YES/NO
SIGNED………………………………………………………………………Parent/Guardian
THIS SECTION TO BE COMPLETED BY CHURCH LEADER
Name of vicar / priest / minister / church officer . . . . . . … . .. . . . . . . . . . . . ……….. . . . . . . . .
Contact Telephone Number……………………………..…………..
Name of place of worship ……………………..………
Religion/Denomination…………….…
I confirm that the child named above and the parent/guardian named above have attended the
above-mentioned church at least fortnightly for at least one year prior to signing of this form.
SIGNED…………………………………………. Vicar/priest/minister/ church officer
DATE………………………………………
TO BE RETURNED TO
St. Thomas’ Moorside C.E. (V.A.) Primary School,
Coleridge Road, Sholver, Oldham OL1 4RL
ALL SUPPLEMENTARY FORMS WILL BE ACKNOWLEGED BY THE SCHOOL WITHIN 7 DAYS. IF YOU DO
NOT RECEIVE A RECEIPT FROM SCHOOL, THE SCHOOL HAS NOT RECEIVED YOUR FORM(S). IN THIS
INSTANCE, YOU MUST CONTACT SCHOOL IMMEDIATELY ON 0161 624 9290
EXCERPT FROM SCHOOL ADMISSION POLICY
THE FOLLOWING IS AN EXCERPT FROM THE SCHOOLS’ FULL ADMISSION ARRANGEMENTS AND POLICY
DOCUMENT. A COPY OF THE FULL DOCUMENT CAN BE OBTAINED BY CONTACTING THE SCHOOL OFFICE
At annual allocation of Reception class places for September, any child with a statement of special
educational needs, where that statement names the school, will be offered a place before any
other children are admitted.
Where there are more applicants than available places, the decision on which children will be admitted
will be based on the following oversubscription criteria :
1.
2.
3.
4.
5.
6.
7.
8.
Looked after children and previously looked after children who were looked after, but ceased to be
so because they were adopted (or became subject to a residence order or special guardianship
order)’
Children whose exceptional medical or social circumstances mean that their needs can only be
met at this school (see note a)
3 places will be allocated to children based on geographical proximity to the school (see note f).
Children who, along with one or more parent or legal guardian, regularly attend St. Thomas’
Moorside Parish Church. (see notes b and c)
Children who, along with one or more parent or legal guardian, regularly attend other Anglican
Churches (see notes b and c)
Children who will have an older brother or sister attending the school as a pupil during the year of
admission. (see note d)
Children who, along with one or more parent or legal guardian, regularly attend churches of other
Christian Denominations (see notes b and c)
Any other children in order of proximity to the school (see note e)
Notes:
a) Where admission is sought under special medical or social circumstances criteria, professional
supporting evidence, e.g. from a doctor, psychologist or social worker, is essential. Such evidence
must set out the particular reasons why the school is the most suitable for the child and the
difficulties that would be caused if the child had to attend another school. This supporting evidence
should be submitted to school along with the school’s supplementary form 1, which parents should
obtain directly from the school. The closing date for returning supplementary forms to the school will
be the same as for the Local Authority’s common application form.
b) Regular attendance is a minimum of fortnightly attendance at church at public worship for at least
one year prior to submission of the application. Evidence of regular attendance of parent(s)/
guardian(s) must be provided by a member of the clergy or other designated church officer on
supplementary form 2 provided by the school (see note c).
c) Parents who wish church attendance to be taken into consideration when applying for school must
request and complete the school’s supplementary form 2, which parents must obtain directly from
the school. The closing date for returning supplementary forms to the school will be the same as for
the Local Authority’s common application form. Although completion of the school’s
supplementary forms is not compulsory, applicants who do not complete and return the
school’s supplementary forms by the deadline stated will not be considered under criteria 2)
4) 5) or 7) of the oversubscription criteria above [see also note d) with respect to siblings
living apart].
d) ‘Brother’ or ‘sister’ includes full, step, half, foster and adopted brothers or sisters living at the same
address. Where there is a full sibling already attending the school but living at a different address
(siblings living apart), this will only be taken into consideration where parents complete and return
the school’s supplementary form 1, which parents should obtain directly from the school. The
closing date for returning supplementary forms to the school will be the same as for the Local
Authority’s common application form.
e) Where there are more applicants than available places within a category, then priority will be given
to those children living closest to the school. This will be determined, using a Geographical
Information System, Post Office Post Code data and Ordnance Survey mapping data, and will
calculate the distance between the normal home and the school for all children who apply. All
distance measurements will be in a straight line between the two geographical data points of the
home and the school, with those living closer to the school receiving the higher priority. The ‘normal’
home of the child will be taken to be the home in which the child sleeps for the majority of the school
week.