Application for a Place in Prudhoe West Academy 2 Year Olds Unit
Our 2 Year Olds Room operates in conjunction with our Shining Stars Kids’ Club offering childcare from 7.30am – 6pm term time.
We offer both funded and privately paid for places.
For further information about session times and prices please contact the school office.
Name of Child
Date of Birth
Prefer not to say
Name of Parent 1
Name of Parent 2
Home Telephone Number
Mobile Telephone Number
Other Children in the Family? Names, Ages and Schools (If applicable)
Present arrangements for supervision of child during the day
Please give any details of any Nursery/Playgroups or Mother and Toddler Groups attended
Page 1 of 4
Never submit passwords through Google Forms.
This form was created inside of Wise Academies.