Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Nursery Places
An expression of interest form. You can complete the form for children that are 3 years old from January 2025 and 2 years old from September 2025.
* Indicates required question
Email
*
Record my email address with my response
Child's name
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Prefer not to say
Parent or Carers' Name/s
*
Your answer
Relationship to child:
*
Your answer
Address:
*
Your answer
Contact telephone number:
*
Your answer
Contact email:
*
Your answer
Preferred term start:
*
January 2025
April 2025
September 2025
Required
I would prefer:
*
15 hours of nursery
30 hours of nursery
I am interested in additional wrap around care:
*
Breakfast Club
Lunch Club
Twilight (afterschool club)
Is this expression of interest for a child in the care of the local authority?
*
Yes
No
Does your child have an Education Health Care Plan (EHCP)?
*
Yes
No
Does your child have a special education need but not an EHCP?
*
Yes
No
Do you have any other comments:
Your answer
I understand that completing this form does not guarantee a place at Bushmead Nursery School
Yes
Clear selection
All data will be processed in accordance with our Privacy Policy
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bushmead Primary School.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report