Please fill in our application form to apply for a nursery place at Pickles Childcare.
Full Name of child:
Date of 2nd birthday:
Date of 3rd birthday:
Parent/carer’s address if different:
Time’s, we can contact you:
Place applied for:
---Sessional care: 9.00-4.00Full day care: 8.00-6.00Half Days: 8.00-1.00Half Days: 1.00-6.00
Number of days needed:
Place required from:
All year/term time:
---All year roundTerm time only
---Packed Lunches/TeaOur Meals (additional £3.00 per meal)
Is this a Funded Space?
If YES – What Funding?
---IAM23 & 4year old 15 Hours3 & 4year old 30 Hours
Parent Date of Birth:
Parent National Insurance Number:
Funding Code (IAM2 & 30 Hours only):
Where did you hear about Pickles?
Child’s previous or current Nursery / Childminder / Pre-School
Pickles Childcare is committed to safeguarding and promoting the welfare of children and young people and expects all staff and volunteers to share this commitment. Data Protection Consent
Your Signature on this form is your explicit consent for Pickles Childcare to process personal data relating to you and your child in accordance with the Data Protection Act and General Data Protection Regulation. The information given will be entered onto a computer database and held by Pickles Childcare. Personal data will only be shared as is necessary and always in a fair and lawful manner.
The personal data and information provided will be shared with other agencies as per the above statement and any Privacy Notice applied by Pickles Childcare and only kept for as long as necessary.
Book in for your visit. You and your child will receive a warm welcome from Pickles Childcare.