HITHERFIELD PRIMARY SCHOOL Nursery Application Form
Child's Forename: *
Child's Surname: *
Date of Birth: *
MM
/
DD
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YYYY
Gender: *
First line of address: *
Second line of address:
City: *
Postcode: *
Mobile Number: *
Email Address: *
Name of Parent/Guardian *
Main language spoken at home: *
My brother/sister already attends Hitherfield: *
Required
If you answered yes to sibling please supply name of sibling and class
Does your child have any special educational, physical, medical or social needs? *
Required
If you answered yes, please specify and provide the main office with supporting documentation. Failure to inform the school of any additional needs may result in a delayed start date for your child.
Nursery preference: may tick more than one *
Required
I declare that the information I have given is true. I understand that should any of the information be shown to be false then the school reserves the right to withdraw its offer of a place in this school. *
Required
Signed: Please type name of person making application *
Submit
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