2024- Nursery DC Form 2024- Nursery 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 2022. 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 * MotherFatherStep ParentGuardianOther 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 * MotherFatherStep ParentGuardianOther 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 ParentOther 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) * ReceptionYear 1Year 2Year 3 - AppleYear 3 - LimeYear 4Year 5Year 6 plus1 Add minus1 Remove If you are human, leave this field blank. Next Δ
