Eligibility criteria apply for a 2-3 year old childcare place. Evidence of eligibility must be provided. All children aged 3-4 are eligible for 15 hours free childcare. Limited places for extended hours childcare (30 hours) are available for working parents. Evidence of eligibility must be provided.
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Age 2-3 - 15 hours per week
Age 3-4 - 15 hours per week
Age 3-4 - 30 hours per week
Child's Legal Name
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Forenames and Surname
First Name
Last Name
Child's Date of Birth
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MM
DD
YYYY
Child's Home Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Child's Gender
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Child's ethnicity
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White (English, Welsh, Scottish, NI, British, Irish, Gypsy or Traveller, Roman or any other White background)
Asian or Asian British (Indian, Pakistani, Bangladeshi, Chinese or other Asian background)
Black, Black British, Caribbean or African (including Black British)
Mixed or multiple ethnic groups
Other (eg Arab or other)
Prefer not to say
Child's country of origin
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Language(s) spoken by the child
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Name of legal guardian / parent
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First names and Surname
First Name
Last Name
Parent / Guardian Home Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent / Guardian's contact phone number
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Country
(###)
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Email contact for parent / guardian
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Relationship to child
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Previous school or nursery
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Please advise of any medical conditions that a teacher should be aware of and any medication your child may need to take
Has your child been toilet trained?
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Does your child have any SEND requirements?
Communication and Interaction
Cognition and Learning
Social, Emotional and Mental Health
Sensory and Physical Needs
N/A
Funding Code
Option 1
Option 2
Data protection act 1998. The school is registered under the data protection act for holding personal data. The school has a duty to protect this information and keep it up to date. The school is required to share some of the data with the local authority and department for education. Please provide consent
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