Sankofa Nursery Application Form
Get Started with Sankofa Nursery
This application form is for parents applying for a nursery place at Sankofa Nursery. Once your form has been completed and submitted we will contact you to discuss next steps.
Basic Information for Child
Child's Name
*
First Name
Middle Name
Last Name
Child's Gender
*
Please Select
Male
Female
Child's Birth Date
*
Please select a day
1
2
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5
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31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
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2016
2015
2014
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2012
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1924
1923
1922
1921
1920
Year
Address
*
Street Address
Street Address Line 2
City
State
Postcode
Nationality
Languages Spoken
Lives with:
Parental Responsibilities
Preferred Start Date
*
Health Information
Does your child have any allergies?
*
Please Select
Yes - Please add details to allergies box below
No
Allergies
Any difficulties with hearing, speech or sight?
Does your child need any specialist equipment (i.e. hearing aids)?
Was your child premature or had low birth weight?
GP Details
Doctor's Name
First Name
Last Name
Doctor's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Doctor's Phone Number
-
Area Code
Phone Number
Sensitive Information
Religion
Ethnicity
Back
Next
Family Information
Parent/Guardian details
Parent #1 Name
*
First Name
Last Name
Relation to child
*
Parent #1 Primary Phone Number
*
-
Area Code
Phone Number
Primary E-mail
*
example@example.com
Secondary E-mail
(optional)
Parent #2 Name
First Name
Last Name
Relation to child
Parent #2 Primary Phone Number
-
Area Code
Phone Number
Parent #2 Primary E-mail
example@example.com
Booking Plan
*
Please Select
Full Time 5 days a week - 8am - 5:45pm
Half Days 5 days a week - 8am - 1pm
Half Days 5 days a week - 1pm - 5:45pm
Would like to discuss - add to additional comments below
Additional Comments for Booking Plan
If you selected 'would like to discuss' , please indicate preferred schedule.
Exceptional Childcare Needs
Clear Fields
Email
example@example.com
Back
Next
Emergency Contacts
Name of Emergency Contact 1
*
First Name
Last Name
Phone Number of Emergency Contact 1
*
-
Area Code
Phone Number
Relation to Child
*
Name of Emergency Contact 2
First Name
Last Name
Phone Number of Emergency Contact 2
-
Area Code
Phone Number
Relation to Child
Supporting Every Child
At Sankofa Nursery, we are committed to inclusive practice and supporting every child to thrive.The questions below help us understand how best to support your child from the very beginning.Information shared will be treated sensitively and used to put the right support in place.
Please detail any agencies involved in the child's life and if you are happy for them to be contacted if needed?
Any dislikes to food/drinks?
Does your child currently receive, or may they benefit from, any additional support with learning or development?
Yes
No
Not sure
Please tell us which areas this relates to (you can tick more than one)
Communication or speech
Attention or focus
Social interaction
Emotional regulation
Sensory needs
Physical development
Other
How does your child usually communicate? (Please tick all that apply)
Uses words or sentences
Uses gestures or pointing
Uses visual support (e.g. pictures)
Speech is sometimes difficult to understand
Uses more than one language
Other
How does your child usually respond to new environments or changes in routine?
Settles easily
Needs extra reassurance
Can become upset or overwhelmed
Finds transitions difficult
Other
Does your child have any sensory preferences or sensitivities we should be aware of?
Noise
Touch
Movement
Food textures
Clothing
Light
Not applicable
Is there anything you would like to tell us about how we can support your child?
Where did you hear about us?
*
Please Select
Sankofa Nursery Website
Word of Mouth
Facebook
Instagram
Day Nurseries
Childcare.co.uk
Google/Search Engine
Current child already attending
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