SAINT GEORGE’S (HANOVER SQUARE) SCHOOL SOUTH STREET, MAYFAIR, LONDON W1K 2XH TELEPHONE: 020-7629 1196 FACSIMILE: 020-7641 4920 E-Mail: [email protected] Headmaster: M. Lothian Supplementary Information Form Please complete all information and return to school by 15th January 2013 at the latest. Child’s Surname…………………………………………………………………………… Child’s Forenames…………………………………………………………………………. Date of Birth……………………………………………………………………………… Home address…………………………………………………………………………….. ....…………………………………………………………………………………………… Home Telephone No……………………………………………………………………….. Mobile No………………………………………………………………………………….. Name of Mother or Guardian……………………………………………………………… Name of Father or Guardian……………………………………………………………….. Faith Information Name of Church of England Parish in which you live …………………………………… Name of Minister who can confirm your church/attendance……………………………… A letter from your Vicar/Minister is required confirming at least monthly attendance in the previous year. You will also need to supply a copy of your child’s baptism certificate. Proof of residence must be submitted. Please indicate which of criteria a,b,e -i, admissions criterion your child fulfills by completing the following so that governors may consider your application fully. a. Church of England Looked after children, details: ……………………………………………………………………………………………… b. Children whose parents worship at St George’s/ Grosvenor Chapel at least monthly, and have done so for at least a year. I enclose a letter from the vicar Yes/No ……………………………………………………………………………………………… e.Children whose parents worship at a neighbouring Anglican church. Please state name and address of church, and supply a letter to confirm attendance at least once a month for a year. ……………………………………………………………………………………………… f. Children within the parish of St George’s but of other Christian denominations as defined by Churches Together in Britain and Ireland. Please state name and address of church, and supply a letter to confirm attendance at least once a month for a year. ……………………………………………………………………………………………… g. Children of other Christian denominations as defined by Churches Together in Britain and Ireland. Please state name and address of church, and supply a letter to confirm at least once a month for a year. ……………………………………………………………………………………………… h.Children of other Faiths who live within the parish. Please state name of Faith and name and address of place of worship and supply a letter to confirm attendance at least once a month for a year. ……………………………………………………………………………………………… i. Children of other Faiths who live outside the parish. Please state name of Faith and name and address of place of worship and supply a letter to confirm attendance at least once a month for a year. ……………………………………………………………………………………………… Signed Parent/Guardian……………………………………..Date………………………… .