A1 Registering Interest in Becoming an Academy

A1 Registering Interest in becoming an academy
Thank you for registering your interest in becoming an academy. This form alerts the Diocesan Board of Education (DBE) to your interest in becoming an academy and within which MAT. It also confirms to the DBE that due consideration has been given to this next step with the backing of your school governing board.

There is no need to inform the DfE or the LA at this stage.
School Name*
URN*
School Type*

Voluntary AidedVoluntary ControlledFoundationSingle Academy Trust
Status*

PrimaryInfantJuniorSecondaryThrough
Diocesan Adviser*
Which MAT are you registering an interest in joining?*
Has this been discussed with the MAT?*

YesNo
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
I confirm that this was discussed and agreed by majority at a full quorate governing body meeting.
Date of quorate full governing body meeting where this was discussed and agreed*

MonthDayYear
Date
Extract of Governing Body Minute*

Cancelof
In giving due consideration, I can confirm that governors took the following steps (please tick any that apply)*

Discussion with named Diocesan Adviser.Attendance at academies briefings led by the Diocese.Held single-agenda item meetings to give full consideration.Governors met with MAT CEO.Governors met with school leaders who are already part of the MAT.Other
Chair of Governors Signature*

Clear
Date of signature*

MonthDayYear
Date
Should be Empty:

A1 Registering Interest in becoming an academy