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APPLICATION FOR ADMISSION TO NURSERY AGED SETTINGS 2014

Before completing this form you should read all of the information in the booklet carefully. You should complete and return your application to your preferred setting by the closing date of 3 March 2014in order for it to be considered alongside other applicants. Do not complete more than one application form since you will be contacted and asked to withdraw your application.

CHILD’S DETAILS

Child’s Legal Surname*:Date of Birth:

Child’s Legal First Name*: MaleFemale

* As indicated on the child’s birth certificate

Full Postal Address:

Postcode:

Is your child a twin or triplet, etc (one of a multiple birth)? YesNo

If yes please provide the names of the related applications:

Please tick each box as appropriate / Yes / No
Is this child in the care of a local authority?
Has the child previously been in the care of a local authority but has since been adopted (or become subject to a residence order or special guardianship order?
From a returning Service/Crown Servant family?
Does this child have a statutory statement of educational need?

NURSERY/FOUNDATION CLASS PREFERENCES

List the name of the school(s) where you would prefer your child to attend a nursery or foundation class in ranked order. Please see the directory for a list of eligible maintained nursery settings. You may give the reasons for your preferences overleaf.

Names of Preferred Nursery/Foundation Class School DfF Number

(see the booklet)

1st:

2nd:

DETAILS OF ELDER BROTHER OR SISTER ATTENDING EITHER OF YOUR PREFERRED SCHOOLS

If your child has an elder brother or sister already at one of your preferred schools, or an affiliated Junior school, who will still be in attendance in September 2013please give details below:

Name of Elder Brother or SisterSchool Date of Birth Current Year Group

PREFERENCES FOR CATHOLIC and CHURCH OF ENGLAND AIDED SCHOOLS ONLY

I have attached additional information required as specified in the admissions criteria of my preferred Catholic or Church of England /AidedSchool (please tick to indicate documents attached):

Has your child been Baptised a Catholic? NO YES If YES, a copy of the baptismal certificate must be enclosed with this form. If the above information and a copy of the baptismal certificate arenot supplied then it will cause a delay in processing your application and may affect the outcome.

REASONS FOR PREFERENCE

Please use the space below if you would like to add any additional information in support of your preference(s). You may continue on a separate sheet if necessary. Any additional information provided should refer to the admissions criteria published in the Admission to Nursery Age Settings – 2014/15 booklet.

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DETAILS OF PERSON COMPLETING THIS FORM

Surname: ______Please indicate titleMr / Mrs / Miss / Ms

First: ______

Relationship to Child: ______

Mobile Number: ______

Telephone Number: ______

Email Address: ______

If you are caring for someone else’s child for more than 28 days and are not an immediate relative, you may be privately fostering and it is a legal requirement that you contact the local authority on 0800 1313126. Further information is available at

DECLARATION AND SIGNATURE OF APPLICANT

The information provided on this application form will be used to ensure that the council’s records are correct. It may also be shared with other agencies and service providers to ensure that your child receives an appropriate service.

Declaration: I certify that the information I have provided is true to the best of my knowledge, and understand that any false or deliberately misleading information provided on this form and/or supporting papers may render this application invalid and could lead to the withdrawal of an offer of a school place for my child. I also give my consent for the School Admissions and Transport Service to contact relevant agencies in order to validate this application.

Signature: Date:

Please ensure that you have read all of the information contained within the accompanying booklet before returning this form.

Notes

  • If you are making your application on the grounds of medical or exceptional circumstances, it is important that you provide additional information and documents, such as a letter from your Doctor, Social Worker,etc. as your request will not be considered under this criterion unless this information is provided with your application form.
  • For admission purposes, pupils will be deemed to live at the same address as the parent that they have lived with in the previous school year. If your child has lived with more than one person with parental responsibility, the home address will be classed as the address the pupil has been resident at for the greatest number of school days. It may be necessary for parents to provide documentary evidence of their address in support of their application.
  • If your child is offered a nursery/foundation place this will not guarantee later admission to the primary school.
  • Please return this form by the closing date of 3March 2014, to the school you have named as first preference in Section 2.

If you require any help or advice contact the School Admissions and Transport Service by email - or by telephone - 01785 278593