Nursery Application Form - September 2022 Admission Question Title * 1. The school uses the following criteria for admissions into our Nursery. The tie-breaker for all criteria is children living closest to the school (measured in a straight line using a computerised mapping system. The school is planning to offer places for 30 hour provision and places for 15 hour provision. This is subject to change based on demand. All places offered will follow the criteria for admissions. Please select the ONE admission criterion you are applying under from the list below. 1st Children with special educational needs identified through a statement issued under the Education Act 1996 which names the school, or children in care of the local authority, or who are subject on an Education Supervision Order under the Children Act 1989 which names the school. Please provide evidence to the school within one week of this application. 2nd Children whom the Director of the Children's Service accepts have an exceptional medical, social or educational need for a place at the school nursery. Applications will be considered under this category if they are supported by a written statement from a doctor, social worker or other appropriate professional. In each case, the connection between the child's need and the specific school applied for must be clearly demonstrated. Please provide evidence to the school within one week of this application. 3rd Children who will have a brother or sister attending the school at the time of admission. The category includes foster brothers and sisters, half brothers and sisters or stepbrothers and sisters. Parents/carers should note that in all these cases, the brother or sister must be living at the same address as the child for whom the application is being made. 4th To ensure, as a school, we are able to maintain an outstanding quality of teaching, the allocation of a nursery place to a member of school staff will also be considered. 5th Children living closest to the preferred school. Distance will be measured by straight line using a computerised mapping system. OK Question Title * 2. If you are applying under the sibling criterion number 3 please enter the sibling names here. Please ignore this question if you are applying under any other criterion. OK Question Title * 3. What is your CHILD'S SURNAME? OK Question Title * 4. What is your CHILD'S FIRST NAME? OK Question Title * 5. What is your CHILD'S DATE OF BIRTH? Date / Time Date OK Question Title * 6. What is your CHILD'S GENDER? Male Female OK Question Title * 7. What is the NAME OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? OK Question Title * 8. What is the RELATIONSHIP TO THE CHILD OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? OK Question Title * 9. What is the ADDRESS OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? The address must be the address which is the child's main residence and with the adult/s who has or have parental responsibility. Proof of address will need to be provided to the school. OK Question Title * 10. What is the POSTCODE OF THE ADDRESS OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? OK Question Title * 11. What is the HOME TELEPHONE NUMBER OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no landline telephone number. OK Question Title * 12. What is the MOBILE TELEPHONE NUMBER OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no mobile telephone number. OK Question Title * 13. What is the WORK TELEPHONE NUMBER OF THE FIRST PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no work telephone number. OK Question Title * 14. What is the NAME OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no second person with parental responsibility. OK Question Title * 15. What is the RELATIONSHIP TO THE CHILD OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no second person with parental responsibility. OK Question Title * 16. What is the ADDRESS OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no second person with parental responsibility. OK Question Title * 17. What is the POSTCODE OF THE ADDRESS OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no second person with parental responsibility. OK Question Title * 18. What is the HOME TELEPHONE NUMBER OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no landline telephone number or no second person with parental responsibility. OK Question Title * 19. What is the MOBILE TELEPHONE NUMBER OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no mobile telephone number or no second person with parental responsibility. OK Question Title * 20. What is the WORK TELEPHONE NUMBER OF THE SECOND PERSON WITH PARENTAL RESPONSIBILITY? Please enter N/A if there is no work telephone number or no second person with parental responsibility. OK Question Title * 21. What E MAIL ADDRESS should Rhodes Avenue Primary School use to communicate with you regarding the outcome of this nursery application? OK Question Title * 22. Please list the FULL NAMES OF ANY SIBLINGS WHO WILL BE ATTENDING RHODES AVENUE PRIMARY SCHOOL AT THE TIME OF THE NURSERY ADMISSION IN SEPTEMBER 2020. Please enter N/A if this does not apply. OK Question Title * 23. The school is planning to offer places for 30 hour provision and places for 15 hour provision. This is subject to change based on demand. Please select which NURSERY PROVISION you are applying for. Please select one option only. I require a full time (30 hours per week term time) nursery place. I require a part time (15 hours per week term time) nursery place. OK Question Title * 24. Please answer this question if you are applying for a full time (30 hours per week term time) nursery place. Please skip to the next question if you are applying for a part time (15 hours per week term time) nursery place. Not all parents are eligible to receive the 30 hours provision for free. Please check your eligibility by logging onto the following website: www.gov.uk/30-hours-free-childcare. Parents must apply online for 30 hours. You must have a valid code by the end of the month before a new term starts and this is a parents' responsibility to ensure this is in place. You have to reconfirm your eligibility every 3 months. If you apply more than 3 months before the term starts, you’ll have to reconfirm your eligibility in your account in order to keep your code valid. Parents not eligible for the full 30 hours free provision place will receive the first 15 hours free and will be charged for the additional 15 hours. The additional charge is £30 per day. I am eligible to receive the government's 30 hours of free early education and wish my child to take up the full 30 hours provision on offer at Rhodes Avenue Primary School, currently Monday - Friday 9am - 3pm (subject to change and will be confirmed in my nursery offer if my application is successful). I am not eligible to receive the government's 30 hours of free early education and wish my child to take up the full provision on offer at Rhodes Avenue Primary School, currently Monday - Friday 9am - 3pm (subject to change and will be confirmed in my nursery offer if my application is successful). I understand that I will receive 15 hours of free early education and agree to pay for the additional 15 hours per week at a charge to me of £30 per day. OK Question Title * 25. Please answer this question if you are applying for a part time (15 hours per week term time) nursery place. Please skip to the next question if you are applying for a full time (30 hours per week term time) nursery place. If you would like to apply for the universal 15 hours of free early education and wish your child to take up 15 hours at Rhodes Avenue Primary School please indicate which option you would like.Option 1: Monday full day (9am-3pm - subject to change), Tuesday full day (9am-3pm - subject to change) + Wednesday morning (9am - 12 noon - subject to change)Option 2: Wednesday afternoon (12 noon-3pm - subject to change), Thursday full day (9am-3pm - subject to change) and Friday full day (9am-3pm - subject to change). Option 1 Option 2 OK Question Title * 26. Please indicate whether you will may be requiring any BREAKFAST CLUB sessions for any of the days your child will be attending nursery. If your nursery application is successful you will then be able to select the days you require. Our breakfast club operates from 7.40am-9am at a charge of £4.50 (subject to change) per day. Yes - It is likely that I will require some Breakfast Club sessions. I can apply for days if I receive a nursery offer. No - It is unlikely at this moment that I will require Breakfast Club sessions. I can apply for sessions if I receive a nursery offer. OK Question Title * 27. Please indicate whether you will may be requiring any AFTER SCHOOL CLUB sessions for any of the days your child will be attending nursery. If your nursery application is successful you will then be able to select the days you require. Our After School Club operates from either: 3pm-4.30pm at a charge of £6 (subject to change) per day or 3pm-6pm at a charge of £12 (subject to change) per day. Yes - It is likely that I will require some After School Club sessions. I can apply for days if I receive a nursery offer. No - It is unlikely at this moment that I will require After School Club sessions. I can apply for sessions if I receive a nursery offer. OK Question Title * 28. Children attending a full day (9am-3pm - subject to change) will require a lunchtime meal. Please indicate who will be providing your child's lunchtime meal. I will provide a packed lunch for my child on any days s/he is attending a full day. I can change my mind if I receive a nursery offer. I will require a school meal for my child on any days s/he is attending a full day and understand that there will be a £2 (subject to change) per day charge for the school meal. I can change my mind if I receive a nursery offer. OK Question Title * 29. Two pieces of evidence are required as proof of address and must be no older than 6 months at the time of the nursery application. One piece of evidence must be a Council Tax Bill and one piece of evidence must be a utility bill, e.g. electricity, gas or water bill. Parents should note that childminders' addresses, including private arrangements with family members will not be taken into consideration. In the event of your child being offered a place further proof of address may be required. These must be forwarded to us within one week of making this nursery application by e mailing scanned copies to: admissions@rhodes.haringey.sch.ukPlease write your child's full name and date of birth on thesePlease confirm that you will be providing the required pieces of evidence with your nursery application. I will forward within one week of making this nursery application the two pieces of evidence required as proof of address. OK Question Title * 30. A copy of your child's birth certificate must be forwarded to the school (the school may ask to see your child's original birth certificate at a later date if you receive a nursery offer). A copy of the birth certificate must be forwarded to us within one week of making this nursery application by e mailing a scanned copy to: admissions@rhodes.haringey.sch.ukPlease confirm that you will be providing a copy of your child's birth certificate as evidence with your nursery application. I will forward within one week of making this nursery application a copy of my child's birth certificate. OK Question Title * 31. Please read the following statement:I, the undersigned as Parent/Carer/Guardian of the child named within this nursery application, declare that the information given in this application and the information I will forward to the school within one week is true, correct and complete.Please provide the full name of the person making this nursery application and their relationship to the child. OK PRESS HERE TO SUBMIT YOUR NURSERY APPLICATION. PLEASE NOTE, YOU WILL NOT RECEIVE CONFIRMATION.