Nursery Expression of Interest Form

Parent/Guardian details

Your name *

First

Last

Your phone number *

Your Email address *

Your address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Child's details

Child's name *

First

Last

Child's date of birth *

Child's sex *

Application options

We are interested in *

2 - 3 year old places

Some families are entitled to free provision from the start of the term after the child has turned 2.
There are 2 different schemes:-
1) Some families are entitled to free provision from the start of the term after the child has turned 2.
2) Some families are entitled to working parents 30 hour funding from when their child is 9 months old & can use it with us from the start of term after their child has turned 2.

30 your be

Are you entitled to free 2 year old provision?

3 - 4 year old places

1) All children are entitled to 15 hours provision from the start of the term after the child has turned 3.
2) Some families are entitled to working parents 30 hour funding from when their child is 9 months old
More information is available at the following websites:
Best Start in Life
Southwark Early Years Entitlement

Are you entitled to free 30 hours provision?

Please provide any further information about the place you would like.

When do you want the place for? *

Siblings

Does your child have any siblings who already attend Surrey Square Primary School? *

'Looked after child'

Is your child a 'Looked after child'? *

If the child is currently 'Looked After' please provide a letter on headed paper from the local authority in England where the child is currently 'Looked After'.If the child was 'Previously Looked After' by a Local Authority, please provide a copy of the relevant court order under English law such as an adoption order, a child arrangement order or a special guardianship order.'Previously Looked After' children include those children who have been in state care outside of England and ceased to be in state care as a result of being adopted. If this applies to your child, please provide evidence of this.