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AF00106654 School file Dubbo 5-15725.5 - Flipbook - Page 4


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ANNEX TO APPLICATION FOR CERTIFICATE TO A DENOMINATIONAL SCHOOL.
WE the undersigned Parents (or Guardians) of Children residing within the undermentioned distances
from the site of the proposed Denominational School at
hereby undertake that our Children, whose names are inserted below, shall attend the said School.
NAME OF PARENT OR GUARDIAN.
(To be written by himself.*)
DISTANCE
FROM
SCHOOL.
RELIGIOUS DENOMINATION.
NAME OF CHILD.
*r)4,
-*/
/ l'e41,10)r4
ve-A.4. ID
P4491
f,_ • f
(4 eazi-7,,,,
a
If the Parent or Guardian be unable to write, hiszaark must beoyitlessed
di V
/Zia
allember
4)?1,i/4fr6a-
44.
A5L__D
he Local Committee.

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