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Nursery Admission Form September 2024/25
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Email
*
Your email
Please note our Nursery is only for children who are
aged between 3 and 4 years old
. Your child should be aged 3 and/or turning 4 between September 2024 and August 31st 2025. We do also offer 3 year provision options with a January or April 2025 start.
PUPIL'S DETAILS
Child's Legal First Name
*
Your answer
Child Middle Name
*
Your answer
Child's Legal Last Name
*
Your answer
Child's Date of Birth (Day/Month/Year)
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Other:
Place of Birth (Include Country)
*
Your answer
Permanent Full Address
*
Your answer
Date of when you moved to this address
*
MM
/
DD
/
YYYY
Name of the previous (Current) Nursery and Borough
Your answer
Date your child started the previous (current) nursery (Day/Month/Year)
MM
/
DD
/
YYYY
Date your child ended at the previous (current) nursery (Day/Month/Year)
MM
/
DD
/
YYYY
Name of any siblings attending Mitchell Brook School (Full Name and Year group)
Your answer
Name and age of any siblings living in the family home but not currently attending Mitchell Brook.
Your answer
Please state the reasons for moving to Mitchell Brook Primary School
*
Close proximity to School
Recently moved to the Country
Recently moved to the Borough
Not satisfied with Current School
Relatives at the School (Sibling/Cousins)
Recommended by Family/Friend etc
School Ofsted Rating
Sibling currently at the School
We were former pupils and would like for our child/ren to also attend
We were home schooling but would now like our child to attend a school
Great relationship with the School
We heard the school has good SEN support
Other:
Required
Who has legal responsibility for the child?
*
Mother and Father
Mother only
Father only
Other:
Who is the child's main carer?
*
Mother and Father
Mother only
Father only
Other:
Is this child living with their birth family?
*
Yes
No
Please indicate your preferred provision:
*
Monday - Wednesday AM (Part Time)
Full Time
*Please note*
If you would like a full time place you will need to provide the information listed below
or you can pay the top up of £75 per week, for the additional 15 hours.
Would you be interested in your child starting with us a term early (Summer term 2024)
*
Yes - Part-time (Monday - Wednesday AM)
Yes - Full time
No - wish to wait until September 2024
National Insurance Number:
*
Your answer
Date of Birth of the Parent who applied for the 11 digit code provided by HMRC:
*
MM
/
DD
/
YYYY
11 digit code provided by HMRC:
*
Your answer
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