BINFIELD PRESCHOOL CONTACT FORM
Contact form for Binfield Preschool
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Email *
Parent Name *
Contact Number *
Email address *
Child's Name *
Child's Date of Birth *
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DD
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YYYY
Provisional requested start date  *
MM
/
DD
/
YYYY
Special Requirements (medical and/or allergies) *
Additional Support Needs *
Any additional information you may wish to share *
Please select your preferred sessions and days from the selection below.  Please be aware that if we are unable to provide you with the sessions required then we may offer you a different session or day.  If none of these are possible then we will place you on a waiting list until a spot becomes available.

Lunch club is available on all days for anyone only attending an AM or PM session. 

Lunch club is not funded and there may be an additional fee to attend.
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Do you qualify for Funded hours?  If yes is it 15 or 30 Hours?  Please select one of the following options
A copy of your responses will be emailed to the address you provided.
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