Nursery Application Form - September 2024 Intake
Please complete and submit this form by Monday 4th March 2024
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YOUR CHILD'S DETAILS
First Name *
Middle Name(s) *
Surname *
Date of Birth *
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DD
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Gender *
Required
NHS Number *
Your child's permanent address *
Special Educational Needs: Does your child have a Statement of Special Educational Needs or an Education, Health & Care Plan? *
At risk: Is your child, or a sibling of your child, the subject of an inter-agency child protection plan and been placed on the Child Protection Register? (If yes, please provide evidence). *
Children in Public Care: Is your child looked after (or was previously looked after)? *
Social or medical reasons: Does your child have a particular medical or social need to go to this school? (If yes, please provide supporting evidence). *
If your child has a sibling at Stonehill School, please enter their name and date of birth.
If your child attends, or has attended, an early years setting, please enter its name:
I am interested in, or will be eligible for, a 30 hour funded place for my child.
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If you have any special requirements, please complete details here.
PARENT/CARER DETAILS
Parent/Carer 1 Title *
First Name *
Surname *
Date of Birth *
MM
/
DD
/
YYYY
National Insurance Number *
National Asylum Support Service (NASS) Number (if applicable)
Address *
Email address *
Daytime telephone number *
Parent/Carer 2 Title
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First Name
Surname
Date of Birth
MM
/
DD
/
YYYY
National Insurance Number
National Asylum Support Service (NASS) Number (if applicable)
Address
Email address
Daytime telephone number
DECLARATION
The information I have given on this form is complete and accurate.  I understand that my personal information will be held securely and will be used only for Local Authority purposes.  I agree to Stonehill School using this information to consider my application for a Nursery place.  I understand that if any part of this completed application form is found to be false, the offer of a place will be withdrawn.  I understand that the completion of an application form does not guarantee a place in the Nursery class.  I understand that, if offered a place in the Nursery class, I will have to apply separately for a place in Reception. *
Name of Parent/Carer completing this application *
Thank you for completing this information.  Nursery places will be offered on 18th March 2024.
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