A2 Application to DBE to proceed to conversion to academy status

A2 Proceed to conversion to academy status
Under the Diocesan Board of Education Measure 2021 which led to the subsequent creation of the Leeds Diocesan Board of Education Scheme in 2022, the Diocesan Board of Education ('DBE'), as statutory body and the religious authority for the school, holds approval rights for any school to change its status. In Leeds such a request from a school for a change of status is subject to a formal approval process.

By submitting this application you consent to provide all documentation requested in support of your application.

Your application will be considered by the DBE School Organisation Subcommittee at a date notified to you on receipt of your application.
BEFORE EMBARKING ON COMPLETING THIS DOCUMENT PLEASE NOTE:

The receiving MAT will need to complete sections of this form. Please use the SAVE button which will give you an email link for circulation.

In order to complete this application you will need to upload the following documents:
- Signed minutes of the governors' initial discussion on the academisation.
- Signed minutes resolving to apply for DBE approval to proceed to academisation including specific reference to the receiving MAT.
- Other documents in support of this application (case for conversion and/or consultation documents (if appropriate)).

School Name and address*
URN*
School Type*

Voluntary AidedVoluntary ControlledFoundationSingle Academy Trust
Status*

PrimaryInfantJuniorSecondaryThrough
Diocesan Adviser*
Name of Headteacher*

First NameLast Name
Headteacher Email*
example@example.com
Telephone number(s)

Area CodePhone Number
Name of Chair of Governors*

First NameLast Name
Chair of Governors Email*
example@example.com
Telephone number(s)

Area CodePhone Number
Proposed MAT*
Date of quorate full governing body meeting where this was discussed and agreed*

DayMonthYear
Date

Governors' outline intentions/actions/knowledge
Have the Governors completed form A1 Registering interest in becoming an academy?*

YesNo
Have the Governors carried out any consultations?*

YesNo
Please provide consultation details.
Have the Governors identified who owns the site?*

YesNo
Please provide details of site owners.
Is there a nursery provider/child care or community provision on site?*

YesNo
Please provide details of any nursery/child care or community provision.

Identified benefits for the school
Summarise the identified benefits for pupils.*
Summarise the identified benefits for staff/workforce.*
Summarise the identified benefits in relation to educational standards.*
Summarise the identified benefits for the wider community.*
How do Governors envisage conversion to academy status will preserve and enhance the distinctive Christian foundation of the school?*

Financial
Are there any concerns that you forecast which may be revealed through the MAT due diligence? *
What reserves do the school currently hold?*
Is the school operating a surplus or deficit budget?*

SurplusDeficitOther
What is the amount of the surplus or deficit?*
Please provide projected balances for both in year and carry forward for the next 3 years.*
What are Governors' financial and business plans for the conversion?*
What strengths will the school bring to the MAT following conversion?*

Change of School Name following conversion
Are the Governors considering a change of name for the school on conversion and if so, what name are you considering? *
This will require a separate DBE approval
Documents in support of the application
Extract of the governing body minute resolving to explore academisation. *

Cancelof
Extract of the governing body minute resolving to seek DBE approval to pursue academisation with the identified MAT. *

Cancelof
Other documents in support of this application. (case for conversion and/or consultation documents (if appropriate))

Cancelof
Head

Clear
Date
Chair of Governors

Clear
Date

For completion by the receiving Multi Academy Trust
Name of MAT*
How many academes are in the MAT? (Please include the phase and school type)*
Please summarise the current position in relation to the most recent SIAMS and Ofsted inspections for the academies within the MAT.*
What major challenges do the MAT face in the next 1-3 years?*
How does this application fit in with the MAT growth strategy?*
What benefits will this conversion bring to the school?*
What benefits will this conversion bring to the MAT?*
Give brief details of the secondary and/or primary support available in the MAT.*
How does the MAT intend to preserve and enhance the distinctive Christian foundation of the school?*
What is the MAT's preferred conversion date for the academy? *
Any other comments?
MAT CEO

Clear
Date
Should be Empty:

A2 Proceed to conversion to academy status