Nursery Application Form

Application for admission to the Nursery Class at Hargarve Park Primary School

Fields marked with an * are required

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Please Note: Having a place in the Nursery Class of the school does not afford any priority in relation to admission to the reception class. You will need to complete a separate application form for admission to the reception class.

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Child's Information

Child's First Name *

Child's Surname *

Child's Date of Birth *

Boy/Girl

Boy
Girl

Child's Address (where child normally resides) *

Child's Address Line 2

City *

Borough of Residence *

Post Code *

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Parent/Carer 1

Title *

Parent's First Name *

Parents Last Name *

Contact Phone Number *

11 of 11 Character(s) left

Alternative Phone Number *

11 of 11 Character(s) left

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Parent/Carer 2

Parents First Name

Parents Last Name

Contact Phone Number

11 of 11 Character(s) left

Alternative Phone Number *

11 of 11 Character(s) left

Parents Address *

Address Line 2

City *

Parents Borough of Residence *

Zip *

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Is a brother or sister already attending? *

Current Early Years/Nursery/School provision, If any *

Are there any special medical/social or special educational needs for this child? - Please note that an application on these grounds MUST be professionally supported and a medical / social/ special educational needs report must be attached to this form. *

If yes, please provide more information

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By Submitting This Form You Are Confirming That All The Information You Have Given Is Accurate. The Council Under Section 5(B) Of The Perjury Act 1911 May Decide To Prosecute Any Person Who Knowingly Or Willfully Makes A False Statement Which Would Affect The Success Of Their Application And Could Lead To The Removal Of The Place For Their Child.

Parent's Name *

Date *

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Nursery Application Form

Child's Information

Parent/Carer 1

Parent/Carer 2

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