Pixieland Enrolment form
Email address *
Child Details
Child's first name *
Your answer
Child's last name *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Gender *
Ethnicity *
Start Date *
MM
/
DD
/
YYYY
Home Address *
Your answer
Postcode *
Your answer
Your Mobile number *
Your answer
Invoice email address *
Your answer
Password for invoice *
Your answer
Choose Nursery *
Attendance days required *
Early Start
AM
PM
Additional settings required
None
Monday
Tuesday
Wednesday
Thursday
Friday
Are the sessions grant funded? *
Lunch required (Grant funded only)
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