Blue Coat Church of England School and Music College Supplementary Information Form OFFICE DATE STAMP (DATE RECEIVED) BEFORE COMPLETING THIS FORM, PLEASE ENSURE YOU WORSHIP AT ONE OF THE CHURCHES, WORSHIPPING COMMUNITIES LISTED IN APPENDIX 1 OR A RECOGNISED PLACE OF WORSHIP FOR ONE OF THE OTHER MAJOR WORLD FAITHS LISTED (PAGE 7). PLEASE DO NOT COMPLETE THIS FORM IF YOUR PLACE OF WORSHIP IS NOT LISTED. This form is to be completed by the Parents / Carers or Legal Guardian of the child seeking admission. If you need help to complete this form for any reason, please contact the Office Manager, Blue Coat School, Terry Road, Coventry, CV1 2BA Tel: 024 7622 3542 or email: admin@bluecoatschool.com. (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: Home Address: For which Year Group are you applying (circle) 7 8 9 10 11 Post Code: Male / Female (Please circle) 2. Please tick to indicate which of the following criteria apply to your application: (Further explanations are provided in the Admissions Policy) 1 C of E parent and child can demonstrate frequent participation at a C of E Church 2 CHRISTIAN* parent and child can demonstrate frequent participation see Appendix 1 3 OTHER FAITH* parent and child can demonstrate frequent participation see Appendix 1 * Applicants should note that the Governors of Blue Coat School have taken into account the number of places available to those of other faiths at Secondary Schools in the City. After consultation with representatives of the Roman Catholic Church, the Governors of Blue Coat School have also taken into account the significant number of places at Roman Catholic Secondary Schools in the City. The Governors have decided as a result NOT to give priority to applications from members of the Catholic Church under the Christian criterion, instead giving priority under the other faith criterion. Page 1
3. Please provide the following information about the worshipping community in which your child participates. Please note this MUST be one of the denominations or churches listed in Appendix 1 (Page 7). 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. This MUST be one of the denominations or churches listed in Appendix 1 (Page 7). Name of your additional worshipping community: Denomination: Name of the Minister/Official - this person to complete the declaration at Section 8 Page 2
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 the applicant child has attended on at least 35 weeks during the last 12 months. b) Parent/Carer / Legal Guardian the parent/carer/legal 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/carer/legal 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/Carer/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. PLEASE COMPLETE THE DETAILS BELOW IN BLOCK CAPITALS Name: Signed: Date: Home Phone: Mobile Phone: Email Address: Please also ensure that the supporting declaration(s) in Sections 7 (and 8) are completed. Page 3
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/carer/legal 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, is one of the churches listed in Appendix 1 to this form, or is a recognised place of worship for one of the other major world faiths listed. 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/carer/legal guardian are personally known to me. PLEASE COMPLETE THE DETAILS BELOW IN BLOCK CAPITALS Name: Position held: Contact Address: Contact Phone: Contact Mobile: Contact Email: Signed: Date: Page 4
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/carer/legal 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, or is a recognised place of worship for one of the other major world faiths listed. 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/carer/legal guardian are personally known to me. PLEASE COMPLETE THE DETAILS BELOW IN BLOCK CAPITALS Name: Position held: Contact Address: Contact Phone: Contact Mobile: Contact Email: Signed: Date: Page 5
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 Office Manager at Blue Coat School in the first instance: Telephone: 024 7622 3542 Email: admin@bluecoatschool.com You must return this completed Supplementary Information Form to The Office Manager, 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. Page 6
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 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 2. 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 The Governors of Coventry Blue Coat Church of England School and Music College recognise the following as being the definition of other major world faiths : Buddhism, Hinduism, Islam, Judaism and Sikhism, as well as Roman Catholic. Page 7