Admission Form

Please contact the school office at Harris Primary Academy Peckham Park or Harris Free School Peckham.

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Nursery Application Form v4 01.07.2019.pdf

02nd Jul 2019

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Application for Admission to Harris Nursery Hub - Peckham

(NB - if your child is admitted to the Nursery, they will not automatically be offered a place in Reception Year at Harris Primary Academy Peckham Park or Harris Free School Peckham)

PLEASE DO NOT COMPLETE THIS FORM IF YOU ARE APPLYING FOR A PLACE IN A RECEPTION CLASS
If you would like a physical copy of the application form, please contact us via email: info@harrisnurseryhubpeckham.org.uk
Child's details (all names must be legal names, not preferred names)
Forename(s)*
Surname*
Date of birth*
Age Group Applying for ( 2 or 3 Year)
Home address (as defined in the Nursery Admission Policy - supporting documentary evidence may be required)*
Postcode*
Parent's details (where the child falls into oversubscription category 3 - the children of staff - the employed parent must complete this section)
Full Name*
Contact email address*
Contact telephone number*
Alternative telephone number
Parent eligibility (please refer to the Nursery Admission Policy for full details of the eligibility criteria, indicate the category that applies by ticking the relevant box below):
One or both working full-time and meet the criteria (Minimum 16 hours a week)
One or both studying full-time and meet the criteria
One or both studying and working full-time and meet the criteria
One or both in receipt of listed benefit
Please upload relevant information for parent Eligibility*
Information required to apply oversubscription criteria (please select the appropriate option):
Category 1
Is the child a 'looked after child' or a 'previously looked after child' as defined in the Nursery Admission Policy?*
If the answer to the above question is 'Yes', please attach an original signed letter (or certified copy) from the child's Social Worker confirming the status of the child.
Category 2
Does the child have a sibling (as defined by the Nursery Admission Policy) at Harris Primary Academy Peckham Park or Harris Free School Peckham who will still be on the roll at the time of admission of the applicant child to the Nursery?*
If the answer to the above question is 'Yes', please complete the questions below.
Full legal name of sibling
Date of birth of sibling
Which academy does the sibling attend ?
Category 3
Does the child have a parent employed at Harris Primary Academy Peckham Park or Harris Free School Peckham who meets the criteria set out in oversubscription category 3?*
If the answer to the above question is 'Yes', please complete the questions below.
Date of birth
National insurance number
Category 4
If the answer to all three questions above was 'No', your child will fall into this category.
DECLARATION:

I confirm that the information provided in this application form is true to the best of my knowledge and belief. I understand that, if I have provided false or fraudulent information, any offer of a place will be withdrawn.
Further information about how Harris Nursery Hub Peckham uses information obtained from you about you and your child can be found in its privacy notices which are accessible 'here'

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Admission Form

Page Downloads

Application for Admission to Harris Nursery Hub - Peckham

Child's details (all names must be legal names, not preferred names)

Parent's details (where the child falls into oversubscription category 3 - the children of staff - the employed parent must complete this section)

Parent eligibility (please refer to the Nursery Admission Policy for full details of the eligibility criteria, indicate the category that applies by ticking the relevant box below):

Information required to apply oversubscription criteria (please select the appropriate option):

Category 1

Category 2

Category 3

Category 4

DECLARATION:

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