Experience DayStNicholas’ PreparatorySchool

Registration Form22 SalmonStreet

Kingsbury

London

NW98PN

Tel: 02082057153

Child’sFullName
Child’sDateofBirth / Gender / Proposed
EntryDate
NameofParent/Carer
Address
Postcode
ContactNumbers / Home: / Work: / Mobile:
E-mailAddress / Occupation
NameofParent/Carer
Address
Postcode
ContactNumbers / Home: / Work: / Mobile:
E-mailAddress / Occupation
Pleasestatewhichparentorcarerthechildnormallyliveswith:
Pleasedetailhere, ifapplicable,thenamesofanyotherchildrenofthefamilyattendingtheSchoolorwhoare registeredforentry;oranyotherconnectionwiththeschool,e.g.formerpupils:
Howdidyou firsthearoftheschool?
Pleasegivenameandaddressofthepresentschoolornursery,ifapplicable(withdates):
NameofHead/Manager
Doesthechildhaveany specificmedical conditions/allergiesthat theschoolshouldbeaware of?
Notes:
a)ThisRegistrationFormdoesnotgiverisetoacommitmentbytheschoolortheparents. As registrations are considered in the order that they are received earlyregistrationis recommended. Offersofplacesaresubjectto availabilityand uponmeeting theadmissionrequirementsoftheSchoolatthetimeoffersaremade.
b)Pleasereturnthisformwithyourchequefortheregistrationfeeof£50. TwosignaturestotheRegistrationForm arerequiredifbothparental sectionsabove have been completed.
c)Upon offer a deposit of £700will be required to secure your child’s place at the School.
Declaration
I/Werequestthatthenameofourabove-namedchildberegisteredasaprospectivepupil. Payment forthenon- returnableregistrationfeeof£50isenclosed. Weunderstandandacceptthatthestandardtermsandconditionsof theSchoolwillundergoreasonablechangesfromtime totime.
Parent’s/Carer’sSignature / PrintName / Date
Parent’s/Carer’sSignature / PrintName / Date
Pleasetickyour child’sethnicity(completion ofthissection isvoluntary andalso used for EarlyYears
FoundationStageMonitoring):
White–British
Irish
TravellerofIrish Heritage
Traveller (other)
Anyother whitebackground
Mixed–WhiteandBlack Caribbean
White andBlackAfrican
White andAsian
Anyother mixedbackground
Asian,or AsianBritish
Indian
Pakistani
Bangladeshi
Anyother Asianbackground
Black or Black British
Caribbean
African
Anyother Black background
Chinese
Anyother ethnicgroup–pleasestate:
Pleasetickany ofthefollowingspecialeducational needsthatapply toyour child:
Nospecialeducationalneed
EarlyYearsAction/SchoolAction
EarlyYearsAction Plus/SchoolAction Plus
Pleasetickbelowif your childspeaksEnglishasasecondlanguageandindicatethefirstlanguage spoken:
LANGUAGE:

Jan 2017