Tree Nursery & Preschool Application form

CHILD DETAILS

Kindly add children Photo

Date of application

Date

Name

known as

Date of Birth

Date

Gender

Kindly attach Birth Certificate

Birth Certificate attached

Start Date

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)

Rows	Name	Date of Birth	School
1
2
3

Please give an emergency contact information for your child

Name

Relationship to child

Contact telephone number

Format: (0000) 000-0000.

Contact Address

Name

Relationship to child

Contact telephone number

Format: (0000) 000-0000.

Contact Address

PLEASE TICK APPROPRIATE BOXES FOR PREFERRED SESSIONS REQUIRED

Rows	Sunday	Monday	Tuesday	Wednesday	Thursday
All Day Session 8 AM - 4 PM
Long Day Session 8 AM - 5 PM

Health Declaration and Emergency Contact Details

Disability and Medical Information

Does your child have any long-term illness, medical condition or disability?

If yes please give a brief description

has there been a professional assessment identifying a disability?

If yes please give a brief description

can you provide copies of the professional assessments?

If yes please give a brief description

Does your child have anyknow allergies?

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

Date

What does your child enjoy playing with

Does your child has a dailyroutine of taking a nap

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

Special Dietary Requirements or any food allergies:

If yes please provide details below

Do you agree to use your child photos in any advertising material?

I give my consent for my child to be taken on short outings?

I have given my consent where appropriate on this form

Signed