Admissions Form

Admissions Form
Full name of child*
Child's Date of Birth*

MonthDayYear
Date
Full Address*
Full name of parent/carer*
Parent/carer NI number*
Parent/carer date of birth*
Parent/carer Telephone Number*
Parent/carer Email*
example@example.com
Does your child have any additional needs?*

YesNo
If you believe your child does have additional needs and may need extra support, please speak to the SENCo Team - Kath Childs -- Manager & Sian Cox - Deputy
Session Required*

Monday Morning 09:00-12:00pmMonday Afternoon 12:00-15:00pmMonday All DayTuesday Morning 09:00-12:00pmTuesday Afternoon 12:00-15:00pmTuesday All DayWednesday Morning 09:00-12:00pmWednesday Afternoon 12:00-15:00pmWednesday All DayThursday Morning 09:00-12:00pmThursday Afternoon 12:00-15:00pmThursday All DayFriday Morning 09:00-12:00pmFriday Afternoon 12:00-15:00pmFriday All Day
Parent/Carer Signature*

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Date of Application*

MonthDayYear
Date
How did you hear about St Chads Preschool?*
Should be Empty: