Nursery Application - Westway Trust

First names(s) of child

Surname of child

Child's date of birth

Address

Address line 1

Address line 2

City

Postcode

Parent/Carers name

Relationship to child

Address (if different)

Email

Daytime/work tel

Mobile

City

Postcode

Email (if different)

Daytime/work tel

Home tel (if different)

Mobile

Session request

Preferred start date

Please tick the sessions you would like your child to attend.

Mornings (9.00 - 12:00)

Afternoons (12.00 - 15:00)

All day (9.00 - 15.00)

Terms and Conditions

This application places your child on our waiting list. We will contact you as soon as a suitable place becomes available. Please note that completion of this form does not guarantee a place for your child. Once your child is offered a place and you accept it, on admission further personal information and family details are required for our records. Your child’s birth certificate is required at this point with a copy made for our file. If you find that you no longer need the place, please inform us as soon as possible. Should you decide you no longer need the place we will not retain the details on this application form (see our Privacy Notice).

Please be advised that this application form and offer of a place is subject to our terms and conditions provided to you. By ticking this box, you acknowledge that you have read, understood and agree to these terms and conditions.

I agree to terms and conditions.

Pop Up Nursery, Venture Centre, 103A Wornington Road, London, W10 5YB.

If you have any questions, please call: 07741 248 301.