Application to join (10.3)

Reepham Nursery School’s Application Form
The Pavilion, Stimpsons Piece, Reepham, NR10 4LL
Telephone: 01603-871586 Email: reephamnurseryschool@btconnect.com
Charity Number: 1028915

Personal details

First name(s) of child:

Surname of child:

Date of birth:

Full address:

Postcode:

Parent/carer name (1):

Relationship to child:

Full address (if different):

Postcode:

Daytime/work tel:

Home:

Mobile:

Parent/carer name (2):

Relationship to child:

Full address (if different):

Postcode:

Daytime/work tel:

Home:

Mobile:

Session request

Preferred start date:

Please tick the sessions you would like your child to attend:

Morning (9.30am – 12.30pm)

□ Mon

□ Tues

□ Wed

□ Thurs

Afternoon (12.30pm -3.30pm)

□ Mon

□ Tues

□ Thurs

This application places your child on our waiting list. We will contact you as soon as a suitable place becomes available. Please note that completion of this form does not guarantee a place for your child.

Once your child is offered a place and you accept it, on admission further personal information and family details are required for our records. Your child’s birth certificate is required at this point with a copy made for our file.

If you find that you no longer need the place, please inform us as soon as possible.

Signed parent/carer (1):

Date:

Signed parent/carer (2):

Date:

Please be advised that this application form and offer of a place is subject to your acceptance of our terms and conditions.

For office use only:

Deposit paid:

Date paid:

Tear off the following part to return to the parent(s)

A place will be available for

(child’s name)