St John's Pre-school Nursery Application Form
Please note that this is an application only and does not guarantee a nursery place. Please also note that getting a nursery place does not guarantee a place in the main school when your child reaches school age. A separate application needs to be made directly to the council.
Child's Name
*
First + Middle Names
Surname / Last Name
*
Child's Date of Birth
Male / Female
Child's Address
*
Street Address
Street Address Line 2
City
County
Postcode
Nationality
Languages spoken in the home
Religion
Parent / Carer 1 Info
*
Title (Mr / Mrs / Miss)
First Name
Last Name / Surname
Relationship to Child
*
Home address and postcode
National Insurance Number
Date of Birth
Contact Numbers
Email
Parent 1 Email
example@example.com
Parent / Carer 2 Info
Title (Mr / Mrs / Miss)
First Name
Last Name / Surname
Relationship to Child
Home address and postcode (If different from above)
National Insurance Number
Date of Birth
Contact Numbers
Email
Parent 2 Email
example@example.com
If there is anyone else with parental responsibility whose details have not been entered above then please fill in this section (e.g. separated parent) - otherwise leave blank.
Title (Mr / Mrs / Miss)
First Name
Last Name / Surname
Relationship to Child
Home address and postcode
National Insurance Number
Date of Birth
Contact Numbers
Email
Does your child have any development difficulties / special educational needs (SEN) / communication delays that we can help with?
*
Does your child have any medical conditions or allergies that will require special consideration when at school? (e.g. Asthma, Milk Allergy, Vegetarian, Halal)
*
If new to the area when did you move in?
If new to the area where did you move from?
Names, Dates of birth and schools attended of other brothers / sisters:
Name of primary school you will be applying to:
Please name any other nursery that your child is currently attending:
Will they be attending at the same time as St John's Pre-school Nursery?
Please select which morning sessions you would like for your child? (Our sessions run from 8:50-11:50am, 5 sessions = your government funded 15 hours)
*
Monday
Tuesday
Wednesday
Thursday
Friday
When would you like your child to start? (Tick all that apply)
*
As soon as my child turns three (please ask for current fees / using 2 year old funding)
The term after my child turns three (government funded up to 15 hours)
The year before my child starts main school (government funded 15 hours)
Please state your reason for choosing St John's Pre-school Nursery or any other information you would like us to take into account when considering this application.
By signing you agree that this data will only be used and kept for your application to St John’s Pre-school Nursery and any future funding requests with the council or other educational bodies if your application is successful. You have the right to request the removal of all information held at any time.
Signed by person with parental responsibility
*
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