1. The name of the school is ... ... ... ...
2. The school is a community school.
3. The name of the governing body is ... ... ... ...
4. The governing body shall consist of:
(a)x parent governors;
(b)x LEA governors;
(c)x teacher governors;
(if applicable
(d)one staff governor;)
(e)x co-opted governors (including any governors referred to in paragraph 6, 7 or 8 below);
(f)the head teacher (except at any time when he or she has given written notice to the clerk to the governing body of the school that he or she chooses not to be a governor).
5. Total number of governors ... ... ... ... (except at any time when the head teacher has given notice as above that he or she chooses not to be a governor, when the total number of governors will be ... ... ... ...). (if applicable
6. One co-opted governor will be a governor for whose appointment nominations are to be sought from the minor authority or (as the case may be) from one or more minor authorities in relation to the school).
(if applicable
7. x co-opted governor[s] will be [a] governor[s] for whose appointment nominations are to be sought from the sponsor or from amongst the sponsors of the school.)
(if applicable
8. One co-opted governor will be governor for whose appointment nominations are to be sought from the Education Action Forum for the Education Action Zone in relation to which the school is a participating school.)
9. Subject to regulation 10(2) of the Change of Category of Maintained Schools (Wales) Regulations 2001, this instrument of government comes into effect on (insert implementation date).
10. This instrument was made by order of ... ... ... ... Local Education Authority on ... ... ... ...