Application Form Pre-school 2 Year Olds

Please complete all fields marked (*)

Your first name *

Your last name *

Your email *

Child's first name *

Child's middle name

Child's surname *

Child's date of birth *

Pre-school is from 2 years old

Gender *

2 Year funded places code

Please see our admissions page for a link to check eligibility

30 hours working families code

Please see our admissions page for a link to check eligibility

Sessions required *must be a minimum of 2 sessions on consecutive days *

If you do not have a 2 year supported or working families code sessions are chargeable at £19.50 per 3 hour session

Monday 9am - 12pm

Monday 12pm - 3pm

Tuesday 9am - 12pm

Tuesday 12pm - 3pm

Wednesday 9am - 12pm

Wednesday 12pm - 3pm

Thursday 9am - 12pm

Thursday 12pm - 3pm

Friday 9am - 12pm

Child's home address, including postcode *

Does your child have a sibling at Arlesdene

Previous setting attended by your child

Parent/Carer 1 full name *

Full Name

Date of birth *

Parent/Carer 1 National insurance number *

Relationship to child *

Parental responsibility* *

Is your address the same as the child's *

Your telephone number *

email address *

Parent/Carer 2 full name

Full Name

Date of birth

Parent/Carer 2 National insurance number

Relationship to child

Parental responsibility*

Is your address the same as the child's

Your telephone number

email address

Name of other person authorised to collect your child *

Relationship to child *

Telephone number *

Password *

Medical Information: Child's NHS number You must enter a valid code *

Please enter a valid code

Doctors surgery and address *

Doctors telephone number

Name of Health Visitor

Has your child ever been stung by a bee or a wasp *

Does your child have any health or medical conditions including allergies *

Treatment *

Details including any medication taken regularly *

In the event your child has an accident or is taken seriously ill at school you give permission for staff at Arlesdene to seek further medical advice or treatment *

Does your child have any special dietary needs *

Do you have any developmental concerns about your child *

Does your child have an Educational Health Care Plan or an Individual Education Plan *

Are there any other professionals working with you to support your child, or to support your family

Is your child in receipt of DLA Disability Living Allowance *

Is your child or a sibling of your child the subject of a Child Protection Plan, Child in Need plan or do they have a social worker *

Is your child looked after or have they previously been looked after *

Is your child adopted or under special guardianship *

Ethnicity & Culture ethnic background

First language of child *

Does your child speak English *

Does your child understand English *

Does your child hear any other languages in your family

Religion

I give permission for my child to be photographed and filmed on video for their In the moment planning , any annual group or individual photos and nursery displays. *

I give permission for my child to be photographed and filmed on video for publications on our website, Facebook and press articles. Children's names are never used. In the moment planning , any annual group or individual photos and nursery displays. *

I am willing for my child to join outings organised by the school e.g a short walk, visit to local shops *

Do you have any concerns about your child starting school (for example , speech and language) *

Have you or your family had any recent changes to your family life for example, new baby, moved house or home circumstances *

We use a service called Arbor to send message by email or text. I give consent for Arlesdene to register my email address and mobile number with Arbor *

I confirm that the details above are correct to the best of my knowledge *

I have agreed with our School's Parent Privacy Policy *