Request for a place at Tewkesbury C of E Pre-School

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Email *

What is your name? *

What is your email address? *

Please enter a telephone contact number *

What is your child's name? *

What is your child's date of birth? *

YYYY

Are there any other agencies involved with your child? (e.g. Hearing services, speech and language, social services.) *

Please indicate when you would provisionally like your child to start at Pre - School. *

YYYY

Which days do you require. Tick all that apply. *

None

Monday

Tuesday

Wednesday

Thursday

Friday

Please tick below to indicate the following: *

Yes

15 hour funded

30 hour funded

Fee paying

Funding Code (15hrs/30hrs):

Please enter 15hrs or 30hrs funding code below (if applicable)

Any other comments?

A copy of your responses will be emailed to the address you provided.

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