Prospectus 2012 to 2013 - Broughton Hall High School

REMEMBER YOU ARE STRONGLY ADVISED TO COMPLETE THISSCHOOL SUPPLEMENTARY INFORMATION FORM IN ADDITION TOTHE LOCAL AUTHORITY FORM________________________________________________________________Does your child have a sibling who will be a pupil at Broughton Hall High School inSeptember 2012? Yes No If yes please stateName………………………………………………..………………………………………………..………………………………………………..………………………………………………..………………………………………………..Date of Birth………………………………………………………………………………________________________________________________________________________________Parents’/Guardians’ Contact Telephone Numbers:Home: ............................. Work: ............................. Mobile: …………..…………..I confirm that I have placed Broughton Hall High School as a preference on the formissued by my local Education Authority (please tick if applicable) I confirm that the information I have given is correct.Signed: ………………………………………………….. Date: ……………………Please print name and relationship to child:Name: ………………………………………………………………………………..…Relationship: (Parent, Guardian, etc.) ……………………………………………….._____________________________________________________________________IMPORTANT INFORMATIONa) For Catholic applicants, proof of Baptism must be enclosed.b) For other Christian applicants, proof of Baptism or a letter from a minister of religion mustbe enclosed.c) For non-Christian faiths a letter from a religious leader confirming membership of the faithmust be enclosed.d) For all applicants, proof of permanent home address must be enclosed. e.g. council tax bill,utility bill, tenancy agreement, exchange of contracts.