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Nursery Application 2023 - Late
Nursery 30 hours will be Monday to Friday 8.50am-2.50pm
Nursery 15 hours will be either:
Monday and Tuesday 8.50am-2.50pm and Wednesday 8.50am-11.50am
Wednesday 12pm-3pm, Thursday and Friday 8.50am-2.50pm
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* Indicates required question
Email
*
Your email
Child's Name
*
Your answer
Gender
Male
Female
Clear selection
Date of Birth
*
MM
/
DD
/
YYYY
Child's Address
Your answer
Preference - please tick one option
*
30 hours - 5 days per week (30 hour code)
30 hours - 5 days per week (paid)
15 hours - 2.5 days Wed pm, Thurs, Fri
15 hours - 2.5 days Mon, Tues, Wed am
Other:
Required
Is the child a looked after and or previously looked after?
*
Yes
No
Other:
Does your child have any special education needs, special social needs or a a disability?
*
Yes
No
Were a child has a sibling attending the main school or northmead at the timeof admission or is expected to have a sibling attending
Yes
No
Clear selection
Please provide the name(s) and dates(s) of birth of siblings and year group(s) expected to be in at september 2023
Your answer
Does your turn 4 years old between 1 September 2022 and 31 August 2023
*
Yes
No
Children who will be 3 years old between 1September 2022 and 31 August 2023
*
Yes
No
Parent/ Guardian/ Carer's Name 1
*
Your answer
Relationship to Child
*
Mother
Father
Step Parent
Foster Parent
Social Worker
Other Family Member
Other Contact
Other relative
Address
*
Your answer
Daytime telephone number
*
Your answer
Email address
*
Your answer
Parent/ Guardian/ Carer's Name 2
*
Your answer
Relationship to Child
*
Mother
Father
Step Parent
Foster Parent
Social Worker
Other Family Member
Other Contact
Other relative
Address
*
Your answer
Daytime telephone number
*
Your answer
Email address
*
Your answer
Is there any additional information you would like to share?
Your answer
We offer the following sessions please choose your preference
*
Monday and Tuesday for 6 hours and Wednesday morning for 3 hours (15 hours)
Wednesday afternoon for 3 hours and Thursday and Friday for 6 hours (15 hours)
Five days Monday -Friday all 30 hours free due to eligibility for 30 hours free entitlement
Five day Monday - Friday but not eligible for 30 hours, so 15 hours funded and 15 hours fee paying at market rates and subject to availabilty
30 hours eligibility code (11 digits)
Your answer
Do you believe your child may qualify for Early Year Pupil Premium (EYPP)
*
Yes
No
Maybe
Name of Parent/Carer signature
*
Your answer
A copy of your responses will be emailed to the address you provided.
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