Tree Nursery & Preschool Application form

Tree Nursery & Preschool Application form
CHILD DETAILS
Kindly add children Photo
Date of application

DayMonthYear
Date
Name
known as
Date of Birth

DayMonthYear
Date
Gender
Kindly attach Birth Certificate

Cancelof
YesNo
Start Date

MonthDayYear
Date
PARENTS/CARE giver (living with pupil)
Person Making Application:
Mother Name
ID no
Address
Home phone
Format: (00) 000-00000.
Mobile phone
Format: (0000) 000-0000.
Other Contact
Format: (0000) 000-0000.
Accupation
email
example@example.com
Father Name
ID no
Occupation
Mobile phone
Format: (0000) 000-0000.
Other Contact
Format: (0000) 000-0000.
email
example@example.com
Sibling Information

Other Children in the family in order of age with the eldest first.

Please note the Child’s Date of Birth (DOB)is to be recorded in the format (DD/MM/YYYY)

PLEASE TICK APPROPRIATE BOXES FOR PREFERRED SESSIONS REQUIRED

Health Declaration and Emergency Contact Details

Disability and Medical Information
YesNo
If yes please give a brief description
YesNo
If yes please give a brief description
YesNo
If yes please give a brief description
YesNo
If yes please give a brief description
In any case of emergency do we have permission to take child to the hospital
Doctors Name
Telephone No
Format: (0000) 000-0000.
Doctors Address
Questions to help us get to know your child

(This will be given to the class teacher)
Childs Name
date of Birth

DayMonthYear
Date
What does your child enjoy playing with
YesNo
If yes from what time to what time
What is your child attitude of napping
When facing difficulty while napping how is it handled
What time does your child go to bed on school night
Does your child have any names for significant people eg grandparents or pets which you would like us to use
Is there any particular likes or dislike that your child has
Are there any ways in which your child might need particular help support from a member of staff
Does your child wear nappies? If toilet trained, how does your child let you know if they need to go to the toilet?
Any other relevant information
Thank you for sharing this information with us to help us get to know your child
YesNo
If yes please provide details below
YesNo
YesNo
I have given my consent where appropriate on this form
Signed
Should be Empty: