Unity Nursery

UNITY NURSERY:

Request for Place Form

If you are interested in a place for your child in Unity Nursery please complete this form and return it to:

Nursery Manager : Jenny Burgeen

Address: Unity Nursery

Warbreck Hill Road

Blackpool

FY2 OTS

PART 1: DETAILS OF THE CHILD

All sections marked with # must be completed

# Surname
# Forename (s)
# Other Surname (s)
# Home Address
# Post Code
# Date of Birth
# Gender
Please indicate if your child is currently attending another Blackpool childcare setting.
Yes o No o
If ‘yes’ please say which …………………………………………………………………

PART 2: THE PERSON MAKING THE APPLICATION

# Full name of the person making this application: Mr/Mrs/Ms/Other (please specify):
Name:
Surname:
# Relationship to the child:
# Telephone Numbers:
Home:
Mobile:
Work:
E Mail Address
If your child is two have you applied for the 2 year education grant?
NO
YES
If yes please provide a copy of your entitlement.

If the child is not living permanently with parents(s)/guardian(s) please provide the name, address and telephone number of the person the child usually lives with and their relationship to the child:

# Mr/Mrs/Ms/Other (please specify):
# Relationship to the child:
# Telephone Numbers:
Home:
Mobile:
Work:
# E Mail Address
Date when the child started living with the person at this address:

PART 3: DETAILS OF THE PLACE REQUESTED

Please indicate which hours you require each day. Fees per hour £5.00 and extra charge sessions are limited and need to be booked in advance.

Term Time
Only / MONDAY / TUESDAY / WEDNESDAY / THURSDAY / FRIDAY
Breakfast Session
8.00am - 9.00am
Extra charge of £5.00 per hour
Morning Grant session
8.45am to 11.45am
Afternoon Grant Session
12.15pm to 3.15pm
Evening Session
3.00pm-5.00pm
Extra charge of £5.00 per hour
Evening Session
3.30pm-5.30pm
Extra charge of £5.00 per hour
All Day
9.00am – 3.00pm
Over 2 days (Grant)

Please delete as appropriate

I will be accessing 15 hours through the 2 year old grant Yes / No

I will be accessing 15 hours through the 3 year old free entitlement Yes / No

I will be paying for some or all of my child’s nursery provision Yes / No

Are you intending for your child to attend Unity Academy? Yes / No

PART 4: DETAILS OF THE CHILD’S BROTHERS AND SISTERS

Name of brother/sister / Date of birth / Name of School/ Nursery attending

* All children qualify for a grant funded early education session from the term following their 3rd birthday. Nursery Education Grant (NEG) funding is available for all 3 and 4 year olds to a maximum of 55 free educational sessions per term, each session being minimum 3 hours duration. Terms will normally be 11 weeks in length but may be up to 14 weeks. Please note the NEG is paid over 3 terms and does not cover school holiday periods.

Date you require your child’s place to start: ______

PART 5: ADMISSIONS CRITERIA

Places at Unity Nursery will initially be offered to all applicants, irrespective of ward, residency or family circumstances. However, once places have been filled, future places will be allocated to children who satisfy the criteria below. The criteria are prioritised to ensure that those who satisfy the highest priority are allocated places. Parents/carers will be expected to provide evidence of the criteria relevant to their circumstances:

1.  A child with a brother or sister already attending the Unity Nursery or Unity Academy

2.  A child who will be applying to attend Unity Academy

3.  A child whose parent /carer is eligible to access Working Tax Credit (including the childcare element)

4.  A child whose parent/carer is undertaking basic skills training

5. A child whose parent is in higher/further education

PART 6: ADDITIONAL INFORMATION

Please provide any additional information that you would like to be considered during the allocation process:

PART 7: TIMESCALES

Timescales for dealing with Unity Nursery admissions are as follows:

·  Request for Place Form to be submitted to the Nursery and the parent/carer advised whether or not there is a suitable place available for their child within ten working days of the Request for Place Form being received;

·  Child to take up the suitable place on a date to be agreed with the Nursery Manager.

·  No more than 50% of places will be promised more than three months in advance of the date required by the parent/carer;

·  An appropriate settling in period for the child will be agreed with the parent/carer and payment will not commence until the child has settled and is ready to take up the place.

·  Agreed fees will need to be paid in advance of child commencing at nursery

·  Places are subject to:

o  All required paperwork being completed

o  All required documentation being provided

o  All contracts, permissions and forms signed as per nursery requirements

PART 8: SIGNATURE

I agree that the information I have provided in this form is correct.

Signed: Parent(s)/Carer(s)……………………………………….. Date……………………….

………………………………………. … Date ………………………

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