Nursery 2021 DC Form Nursery 2021 DC Form 1. PUPIL INFORMATION FIRST NAME * MIDDLE NAME (if any) LAST NAME * PREFERRED NAME (if any) GENDER * Girl Boy Date of Birth * Home Address (including postcode) Nursery Hours * 15 Hour Nursery 30 Hour Nursery 30 Hour Eligibility Code We will need you to submit your eligibility code by 31st August 2021. 2. CONTACT DETAILS We will use this information as your main contact details. MAIN CONTACT NUMBER * MAIN E-MAIL * 3. FAMILY CONTACT DETAILS 3.1 PARENT/CARER RELATIOSHIP TO THE CHILD * Mother Father Step Parent Guardian Other Family Member (siblings,relative) Other RELATIOSHIP TO THE CHILD NAME * E-MAIL * MAIN CONTACT NUMBER * ADDITIONAL NUMBER(S) Address if different from Section 1(including postcode) 3.2 PARENT/CARER RELATIONSHIP TO THE CHILD * Mother Father Step Parent Guardian Other Family Member (siblings,relatives) Other RELATIONSHIP TO THE CHILD NAME * E-MAIL * MAIN CONTACT NUMBER * ADDITIONAL NUMBER(S) Address if different from Section 1(including postcode) 3.3 EMERGENCY CONTACT We must have a third emergency contact, it must be someone other than listed above. NAME * CONTACT NUMBER * RELATIONSHIP TO THE CHILD * Step Parent Other Family Member (siblings,relatives) Other RELATIONSHIP TO THE CHILD ADDITIONAL NUMBER(S) 4. SIBLINGS AT SPRING GROVE Does your child have any siblings at Spring Grove? * Yes No - Go to Section 5 Sibling details Sibling Name * Class (Current) * Reception Year 1 Year 2 Year 3 - Apple Year 3 - Lime Year 4 Year 5 Year 6 Add Remove Next Δ
