Nursery Initial Inquiry Form

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1. Question 1.

Child’s first name(s)

Required - Required.

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2. Question 2.

Child’s surname

Required - Required.

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3. Question 3.

Child’s date of birth

Required - Required.

Date of birth

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4. Question 4.

Child’s gender

Required - Required.

Male

Female

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5. Question 5.

Child’s address (including full postcode)

Required - Required.

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6. Question 6.

Which borough do you live in?

Required - Required.

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7. Question 7.

Which of the following best describes your child’s current toileting status?

Required - Required.

Nappies / Pull-ups

Early stages of potty training

Independently using the toilet

Other (please specify in comments)

This is required

Input box for - Other (please specify in comments)

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8. Question 8.

Parent 1 

Required - Required.

This question requires an answer

Full Name

Relationship to child

Mobile number

Address if different to child

Email

9. Question 9.

Parent 2

Full Name

Relationship to child

Mobile number

Address if different to child

Email

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10. Question 10.

Does your child have any sibling that currently attends Alexandra Primary School?

Required - Required.

Yes

No

11. Question 11.

If yes, sibling name and class

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12. Question 12.

Which nursery session would you prefer? All sessions are subject to availability

Required - Required.

Morning (08:45–11:45 Monday–Friday)

Afternoon (12:15–15:15 Monday–Friday)

30 Hour session 8:45am-12:45pm Monday & 8:45 -3:15pm Tuesday - Friday

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13. Question 13.

Please indicate your 30-hour childcare status

Required - Required.

I do not qualify for a 30-hour free nursery education place

I qualify for a 30-hour free nursery education place but would prefer my child to have a 15-hour place

I qualify for a 30-hour free nursery education place but need to apply for it

I qualify for a 30-hour free nursery education place and have a code

Please write you 30 Hour Code below

This is required

14. Question 14.

Optional additional paid options (select any that apply)

Top-up  2.5 hours per week (£17.50 per week)

Top up session (either am or pm) for an additional fee (£25 per day)

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15. Question 15.

Does your child have any medical or special needs? If yes, please give details

Required - Required.

*

16. Question 16.

Does your child attend a nursery or pre-school setting at the moment?

Required - Required.

Yes

No

17. Question 17.

Current setting (if applicable)

Name

Telephone Number

Borough  

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18. Question 18.

I confirm that the information I have provided is accurate and agree to submit this application

Required - Required.

I confirm and agree