Nursery Application Form
Child's Legal Surname
Child's Legal Forename
Chosen name if different
Child's Full Address (including Post Code)
Child's date of birth (MM/DD/YYYY)
Gender of child
Male
Female
Do any siblings attend this school
Yes
No
Name of sibling/s
Class name the sibling/s in
Does your child have English as an additional language?
Yes
No
What languages does your child speak at home?
Ethnic Group
Please select from list below
White English, Welsh, Scottish or Northern Irish
White Irish
Gypsy/Roma
Any Other White Background
Greek
Turkish
Portuguese
Latin / South / Central American
White and Asian
White and Black African
White and Black Caribbean
Indian
Pakistani
Bangladeshi
Any Other Asian Background
Arab
Black British
Black Caribbean
Black African
Any other Black background
Any other mixed or multiple ethnic background
Any other ethnic group
Please state ethnicity
Religion
Select an option
Christian
Islam
Hinduisim
Sikhism
Judaism
No religion
Other - please state
If 'other' please state
Borough of Residence
Select an option
Southwark
Lambeth
Lewisham
Greenwich
Wandsworth
Croydon
Other
Full Name of Parent / Legal Guardian 1
Relationship to Child
Mother
Father
Other (please state below)
Please state relationship if 'other'
Parent/Guardian 1. Full Address (including Post Code)
Phone Number
Email
Are you a serving member of His Majesty's Forces?
Yes
No
Full name of Parent / Legal Guardian 2
Relationship to Child
Mother
Father
Other
Please state relationship if 'other'
Parent/Guardian 2. Full Address (including Post Code)
Email
Phone Number
Are you a serving member of His Majesty's Forces?
Yes
No
Hours Required
15 hours
30 hours
If 15 hours, is your preference AM or PM
AM
PM
30 Hour Funding Code (if applicable)
(30 hour code) - Eligible Parents Full Name
Date of birth of eligible parent (MM/DD/YYYY)
National Insurance Number
Is your child toilet trained?
Yes
No
Does your child have any medical needs?
Yes
No
Medical Needs - Please state if 'yes'
GP Practice Name and Address
Is there anything you feel your child needs additional support with?
Does your child have an identified special educational need or disability?
Yes
No
Stage of SEN (if known)
Write a message
Has your child recieved support from any other professionals - e.g. Speech and Language Therapist, Occupational Therapist, Paediatrician? If yes, please provide details below.
Child's Birth Certificate
Select a File (If you have a PDF or other file type, please upload a high quality screenshot)
Parent's Photo ID
Select a File (If you have a PDF or other file type, please upload a high quality screenshot)
Council Tax / Utility Bill (past 3 months)
Select a File (If you have a PDF or other file type, please upload a high quality screenshot)
Submit
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