Nursery Interest Form
Thank you for your interest in joining St. Nicholas' Primary School Nursery. 

Please complete the form below. The information will be used for administrative purposes within this school. Please be aware that completion of this form does not guarantee a place for your child.

Please contact school office if you have any questions or queries. 

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Email *
Child's Surname: *
Child's First Name: *
Date of Birth: *
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Home Address *
Postcode *
Parent 1 / Carer name
Parent 1 / Carer contact number. Please enter your mobile and home telephone number.  *
Parent 1 / Carer email address
Relationship to the child
Parent 2 Name
Parent 2 Contact Number
Parent 2 Email Address
Relationship to the child
Are you an asylum seeker or a refugee
If your child has any siblings who attend this school, please provide their names and the class names. 
Please tick your preferred session.  
Morning sessions run from 8.45am - 11.45am
Afternoon sessions run from 12.15pm - 3.15pm  
All day sessions run from 8.45am - 3.15pm.      
Morning Session
Afternoon Session
All Day
Monday
Tuesday
Wednesday
Thursday
Friday
When would you like your child to start nursery?
Are there any developmental, health or physical needs relating to your child which the nursery should know about? If yes please provide details. 
I confirm that the information provided on this form is correct: *
Signed by: *
(Please enter your name)
Dated: *
MM
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