• Home • Up • Age 5 to 11 • Nursery •

For Nursery applications, print and complete the following form.

 

AADMISSION TO A NURSERY CLASS AT

BEATRIX POTTER SCHOOL

 PLEASE COMPLETE IN BLOCK CAPITALS USING BLACK INK

 

 

 

 

 

 

 

1. Details of Child

 

Surname

 

 

First Name(s)

 

 

 

 

 

 

 

 

Date of Birth

 

/         /

 

Boy        

 

Girl     

Please tick

 

 

 

 

 

 

 

 

 

 

 

2. Details of Parent(s) or Guardian(s) With Whom Child Lives

 

 

 

 

 

 

(i)  Surname

 

Initials

 

Mr/Mrs/Miss/Ms

 

 

 

 

 

 

(i)  Home Tel. No.

 

Work Tel. No.

 

Relationship to child

 

 

 

 

 

 

 

 

 

 

 

(ii) Surname

 

Initials

 

Mr/Mrs/Miss/Ms

 

 

 

 

 

 

(ii) Home Tel. No.

 

Work Tel. No.

 

Relationship to child

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

Postcode

 

Borough of Residence

 

 

 

 

 

 

 

 

 

3. Type of place

 

Part-time                  

 

Full-time*                   

Please tick

 

 

 

 

 

If you are requesting a full-time place, are you a single parent in full-time employment or study?

 

Yes          

 

No            

Please tick

 

 

 

 

 

*Please note that the school can only offer a limited number of full-time places to Wandsworth resident children only.

 

 

 

 

 

 

 

 

 

 

4. Details of Siblings        attending this school

 

Surname(s)

First Name(s)

Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Reasons for application

 

If you wish to give reasons for your application, please use the space below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If your child has an acute medical or personal reason for needing a place at this school, you must tick this box and provide professionally supported evidence with your application

 

                                    

 

Medical / Social report attached

 

 

 

 

 

 

 

 

 

6. Declaration

 

1. I understand there is no automatic right of transfer from the nursery class to the infant reception class at the school.

 

 

 

 

 

2. I confirm that the above information is correct to the best of my knowledge and I understand that the Council or school reserve the right to reconsider the offer of a place should the information be incorrect.

 

 

Signature of Parent

 

Date

/               /

 

 

 

 

 

• Home • Up • Age 5 to 11 • Nursery •