Bardykes Farm Nursery School - Application Form

Nursery Application Form

Please allow approximately 30 minutes to complete our online application form ...

Once you have submitted the form in full, we will get in touch to discuss your application and plan the next steps.

Please note no spaces at the nursery will be held until you have paid the registration fee and agreed to a contract with the Nursery Manager.

Child's Forename

Child's Surname

Child's Gender

Female
Male
Neutral

Child's Date of Birth

Birth Certificate District Number

Birth Certificate Year

Birth Certificate Entry Number

Main Carer Full Name

Main Carer - Relationship to Child

Main Carer - Home address

Main Carer - Mobile Number

Main Carer - Home Phone Number

Main Carer - National Insurance Number

Main Carer - Personal Email

Main Carer - Work Company Name

Main Carer - Position at Company

Main Carer - Work Telephone Number

Main Carer - Work Email

2nd Contact - Full Name

2nd Contact - Relationship to Child

2nd Contact - Home Address

2nd Contact - Mobile Number

2nd Contact - Home Phone Number

2nd Contact - National Insurance Number

2nd Contact - Personal Email

2nd Contact - Work Company Name

2nd Contact - Position at company

2nd Contact - Work Telephone Number

2nd Contact - Work Email

3rd Contact - Full Name

3rd Contact - Relationship to Child

3rd Contact - Mobile Number

3rd Contact - Alternative Contact Number

Are all the above contacts able to collect from nursery?

If No Who cannot collect?

Reason Why

Please provide 2 photographs / scans of documents AND child's birth certificate. (email to manager@bardykes.co.uk)

Child Tax Credit Letter
Working Tax Credit Letter
Driving Licence
Bank Statement
Council Tax
Utility Bill
Other
BIRTH CERTIFICATE - THIS MUST BE PROVIDED

Would you like your child to attend the below events

Christmas Party
Annual Trip

Attendance

50 weeks (Excluding Christmas Closure) - minimum 2 days per week
38 weeks (Term Time) - minimum 3 days per week & subject to request

Expected Start Date & Year

2 Settling in Sessions Requested

Intended Primary School

Intended Primary School Starting Year

Asylum Status

Asylum Seeker
Refugee
N/A

Health Information - Health Practice Name

Health Practice - Surgery address

Health Practice - Surgery Phone Number

Health Practice - Health Visitors Name

Does your child have any long-term illness, medical condition, allergies or disability?

If yes, please detail below.

Can you provide copies of professional assessments in relation to above issues?

Does your child have any special dietary requirements or allergies?

If yes, please detail below.

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