Apply for a Place

Child's Full Name

Date of Birth

We will need to see an original birth certificate prior to the child starting pre-school.

Address

Please enter the child's full address and postcode.

Applicant Contact Details - Name of 1st person who has legal parental/guardian responsibility

First

Last

Applicant Contact Details - Address

Please state full address including postcode.

Mobile Number

Email Address

Confirm Email

Contact Details - Name of 2nd person who has legal parental/guardian responsibility

First

Last

Contact Details - Address of 2nd person who has legal parental/guardian responsibility

Please state full address including postcode.

Mobile Number

Email Address

Confirm Email

Emergency Contact Name (should parents/guardians be unavailable)

First

Last

Emergency Contact Address

Please state full address including postcode.

Mobile Number

Email Address

Confirm Email

Child's Doctor

Please include name of doctor and practice address including postcode.

Surgery Phone Number

legal Child's has

Known Allergies, Additional or Special Needs or Medical/Medication Needs

We will be in contact with you prior to offering a place to ensure we have full details of your child's needs

Are you eligible for funding? Please select which type below from the dropdown list

If you are eligible for funding please enter your code or National Insurance Number below

Preferred sessions/days required

Please enter your preferred days/times. For more details please see our sessions page.