Religious Affiliation Form printable pdf download

Religious Affiliation Form

6 Balham Park Road

WARNING: The Authority is under a duty to protect the

London SW12 8DR

public funds it administers and to this end may use the

information you have provided on this form within its

Tel 020 8673 4166

Authority for the prevention and detection of fraud. It may

Data

Fax 020 8675 8887

also share this information with other bodies administering

Protection

Email sao@tsm.wandsworth.sch.uk

public funds solely for these purposes.

Act 1998

Religious affiliation form

If you wish to apply to Trinity St. Mary’s C.E. Primary School under the religious affiliation category in the Admission criteria, please

complete this form

PLEASE COMPLETE IN BLOCK CAPITALS USING BLACK INK

1. Details of Child

Surname

First Name(s)

Date of Birth

Please tick

Boy

Girl

2. Details of Parent(s) or Guardian(s) With Whom Child Lives

Surname

Initials

Mr/Mrs/Miss/Ms

Telephone No.

Mobile No.

Relationship to child

Address:

3. Place of Worship – one of parents / Guardians regularly attends

Name of place of worship:

Address:

Name of Vicar / Priest / Minister / Faith Leader / Church Officer:

Denomination:

Address:

Post Code:

Telephone No.

4. Worship Attendance

Please tick if you have attended a minimum of 1 service per month at least 1 year prior to the closing date for application as

in criteria.

A letter from your incumbent or minister or other church officer is required as proof of this attendance.

Please tick if the letter is attached.

5. Special Medical or Social Circumstances

Tick here if you are applying under this criterion

Give details of professional evidence submitted:

G:\general\Admission Consultation\_2018-19 Consultation\Admission Authority Schools\Determined Admission Arrangements\Primary\SIFs\TSM REligious

Affiliation Form 2018-19.doc

Religious Affiliation Form

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