Nursery Admission Form

Expression of Interest Dewhurst Nursery Form

Please fill out your child's details and preferred admission date.
Child's Name

First NameLast Name
Child's Date of Birth

DayMonthYear
Date
Child's Gender

Other
Parent/Guardian Name

First NameLast Name
Relationship to Child
Parent/Guardian Phone Number
Please enter a valid phone number.Format: 00000 000000.
Parent/Guardian Email Address
example@example.com
Preferred Start Term

Children can start the term after they have turned 3 eg. Child turns 3 in July would start September
When would you be looking to start?
Entitlement to Free Hours

All families are entitled to 15 hours free childcare for 3-4yr olds
Are you entitled to just the Universal free 15 hours or 30 hours free (Both parents must generally earn at least the minimum wage for 16 hours a week) https://www.gov.uk/free-childcare-if-working/check-youre-eligible
Please provide more details
Does you child currently attend any childcare settings?
If yes, please provide details
Does you child have Special Educational Needs?
If yes, please provide details
At Risk?
Children in Public Care ?
Does your child have any medical conditions or allergies)?
You will need to bring your original birth certificate into school after completing this form to verify date of birth. Evidence is also required for children 'At Risk' or with a medical orsocial reason.

Expression of Interest Dewhurst Nursery Form