The Pines Pre School Application form

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Please complete this form to request a place at the The Pines Pre School for your child. On completion you will receive confirmation that your child has been placed on our waiting list, and their potential start date. We will then be in touch again about half a term prior to that start date to see if you still require a place for them.

If you have any questions do please get in touch with us.

Jacqui Pattison
Manager
The Pines Pre School
thepinespreschool@virginmedia.com
07895 454623

Full Name of Child *

Date of birth *

YYYY

Do you expect your child to be entitled to any of the following funding? *

All children are entitled to 15 hours funding from the term after their 3rd birthday. For information about other funding check here - https://www.hertfordshire.gov.uk/services/schools-and-education/childcare-and-advice-for-parents/free-early-education-and-childcare/childcare-support.aspx#

Please note we only start children with us when they are 2 years 6 months

Two year old funding - Families receiving additional government support

Two year old funding - Child in care/adopted/receiving DLA

Two year old funding - Working Families

Three & Four Year old 30 hours funding - Working Families

None - I expect to pay for their fees before they are entitled to the universal 3 & 4 year old funding

Required

Gender *

Male

Female

Other:

Nationality *

Languages spoken at home *

Home address *

Parent name *

Parent phone number *

Parent email address *

How did you hear about the The Pines Pre School?

Recommendation from a friend

Previous child attended

Our website

Publicity leaflet

Hertford & Villages Family Centre

Other:

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Is there any other information you wish to share with us? *

Data retention – we are required to retain the information provided on this application form whilst your child is attending the pre-school, and for a period of time afterwards. Our privacy policy can be viewed at https://www.hertfordcommunitychurch.org/Publisher/File.aspx?ID=211277 or by requesting a copy from a member of staff. If you do not take up the offer of a place at The Pines Pre School this information will be destroyed as soon as you notify us of that decision.

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