Nursery Place Request Form
Pupil Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Gender
*
Male
Female
Other
Pupil Home Address
*
Street Address
Street Address Line 2
Town/ City
State / Province
Post Code
Parent/Carer Title:
*
Mr
Miss
Mrs
Ms
Parent/ Carer 1 Name
*
First Name
Last Name
Relationship to Child
*
Parent/Carer 1 Date of Birth
*
-
Day
-
Month
Year
Date
National Insurance Number
*
Parent/Carer 1 Home Address
*
Street Address
Street Address Line 2
Town/ City
State / Province
Post Code
Email Address
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Format: 00000000000.
Alternative Contact Number (if applicable)
Please enter a valid phone number.
Format: 00000000000.
Previous/Current Nursery Name (if applicable)
School/Nursery Address
Start Date
Leaving Date
Reason for Leaving
Do you have any other children currently attending Whingate? If so, please provide their names below:
We can offer both 15 hour and 30 hour places in our Nursery (limited 30 hours places available for working families only), however places are offered strictly subject to availability and your preferred choice may not be available. Please give an indication below which setting you would prefer for your child to attend:
Mornings (8.45am - 11.45am)
Afternoons (12.15pm - 3.00pm)
2.5 days (Monday - Wednesday AM)
2.5 Days (Wednesday PM - Friday)
30 Hours (Monday - Friday)
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EAL Language Monitoring Form
Please provide us with further information about your child, by giving us details of the below:
Language Spoken At Home:
*
Is this their first experience of school in the UK?
*
What is their understanding of English?
*
Please explain if they can understand simple instructions
What is their spoken English like? Can they communicate basic needs?
*
Any Other Information about your child's needs that you feel we should be aware of?
*
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Agency Involvement
Does your child receive support from external agency services i.e. a Medical/Clinic, Social Care, Speech & Language etc?
*
Yes
No
If you have answered yes, please give as much information as possible below:
Parent/Carer Name
*
Date
*
We require a copy of your child's birth certificate. Please upload a copy here:
*
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