Acceptance form and admissions questionnaire

- Step 1 of 6

Chelwood Nursery School is the data controller for the purposes of the General Data Protection Regulations 2018 and this application form. At Chelwood, we collect personal and/or sensitive information from you about you and your child and may receive information about you and your child from their previous school/setting. If you decide not to continue with this application at any stage, your data will be deleted in line with GDRP legislation. For further information about our Privacy Policy, please refer to our website. *

I acknowledge Chelwood is a data controller for the purposes of this application.

Accepting your child's offer

Name of child (as it appears on their birth certificate) *

First

Last

Date of birth *

I am accepting the offer of a nursery place for my child, who is resident at the address stated in my offer letter and I will provide proof of residence at this address *

Tick to acknowledge

We have been offered the following place: *

15 hours - morning or afternoon (2 year old place)
15 hours - morning or afternoon (3 year old place)
30 hours - 2 year old place
30 hours - 3 year old place
Rising 3 30 hours - (born after 1st Sept but before 31st Dec of the year you are applying for)

2 year old places *

We have a 2 year old eligibility letter from Lewisham
We are going to apply for 2 year old eligibility
We will be paying for our place

Please note, if you have a 2 year old eligibility letter from Southwark, you will need to apply for the equivalent funding through Lewisham. Apply here https://lewisham.gov.uk/myservices/children-and-families/childcare/help-with-childcare-costs/free-early-education-for-two-year-olds

Rising 3 - funding for the first term before your child turn's 3 *

We have a 2 year old eligibility letter from Lewisham Council
We have have a 30 hour DERN working parents code
We will be paying for our first term

We would prefer our place to be:

Mornings
Afternoons
Don't mind

Please note: mornings are our most popular places and because of this we're not always able to offer everyone a morning place. If your personal/work situation means you need a morning place, please discuss this at your admissions meeting.

I believe I will be entitled to receive 30 hours free funding (DERN) from the government and intent to use this funding at Chelwood *

Yes - we already have a 30 hour DERN (Department of Education Reference Number) code.
We will be applying for a 30 hour DERN code
No - we will be paying for additional hours over and above the 15 free hours given by the government.
Not sure yet

30 hour DERN code

NI number (for parent who applied for DERN code)

We would like to extend our place over and above the 30 hours to include Friday afternoons from 1:00pm to 3:30pm. This will be at a cost of £30 per week.

Yes
No
Not sure yet

I understand that it is my responsibility to secure a valid 30 hour code from HMRC the term before my child starts at Chelwood and that I will have to renew this code every 3 months. *

Tick to acknowledge

I understand that if for any reason I do not secure a 30 hour code, or I am unable to renew it during the year, I will have to pay for the additional 15 hours at a cost of £12ph. Alternatively my child will have to reduce their hours to the free 15 hours provided by the government *

Tick to acknowledge

I understand that if I am paying for additional hours over and above the free hours provided by the government then I will have to pay a deposit of £180.00 to secure my place. *

Tick to acknowledge

Would you prefer your admissions meeting to be:

Face-to-face (at Chelwood)
On Zoom
Don't mind

Further information about your child

Is your child: *

Male
Female

Is your child a twin? (if so, please complete a separate application for the other twin)

Child's country of birth *

Family religion or belief (optional)

Child's nationality *

Does your child have a sibling currently at Chelwood?

Name of sibling

Have you previously had a child at Chelwood?

Their name:

Which borough do you live in?

Child’s permanent home address (proof will be required) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Proof of address can be one of the following: a current council tax bill, an energy bill within the last 3 months, a bank statement within the last 3 month.

Details for parents and or carers

Details for 1st parent / carer

Name of 1st parent / carer *

First

Last

Mobile number *

Home phone

Email *

Address *

Address of 1st parent/carer *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Occupation

Language(s) you speak at home *

No. of hours/days worked per week

Would you like an interpreter at your admissions meeting?

Details for 2nd parent / carer

Name of 2nd parent / carer

First

Last

Mobile number

Home phone

Address

Address of 2nd parent/carer

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Occupation

Language(s) you speak at home

No. of hours/days worked per week

Would you like an interpreter at your admissions meeting?

Additional information about your child

This information will help us to begin to understand if your child's has any particular needs and will be discussed further at your admissions meeting.

Doctor's practice

Health Visitor's name

Has your child ever been a 'looked after child' or had a child protection plan, or are they adopted? *

Are any professionals involved with your child or family? *

Speech and language therapist
Hospital consultant
Social worker
Audiology
Portage
Other
None

Paragraph Text

Did your child have a 2 year check with a health visitor? *

Yes
No
Don't know

Does your child have from any diagnosed medical conditions? *

Yes - please provide further details below
No

Has your child been immunised?

Yes
No
Some

Does your child take any regular medication?

Has your child had MMR vaccination?

Yes
No
Don't know

Does your child have any allergies?

Yes - please give details below
No

Further information about medical conditions

Further information about regular medicaion

Further information about allergies

Has your child previously attended any nurseries, childminders, play groups

Nursery
childminder
playgroup
day care
other
No

Details of settings attended, age and for how long

Additional information about your family

This information helps us to plan services for our families and has an impact on the funding we receive to support the children and families at our school.

Do you have Gypsy / Roma / Traveller heritage?

Is your family seeking political asylum?

Do you have refugee status?

Do you have Leave to Remain in the UK?

Do you have an application with the Home Office?

Are you homeless or in temporary accommodation?

Do you receive any of the following?

Income Support
Income Based Job Seekers Allowance
Income Related Employment Support Allowance
Support under Section VI of the Asylum Act 1999
Guarantee Element of Pension Credit
Child tax credit, without any entitlement to Working tax credit, and with an annual income of below £16,190
Universal credit
None of the above

Do you consider you or your child to have a disability?

Additional information

Uploading documents

You need to provide the following information. We cannot schedule the admissions meeting without these documents.

Proof of your date of birth - your child's birth certificate or passport
Proof of your address - your latest council tax bill, or a utility bill within the last 3 months
Proof of your address - Current utility bill (dated within the last 3 months)
Proof of parental responsibility - a copy of your child benefit letter (with your child's name on it) or a letter from a GP/hospital with the child's name on it

Please note: We do need to see the original copy of your child's birth certificate. Please upload a copy of the certificate here and once we offer you a place, bring the original into the office.

Please upload your documents here:

Drag & Drop Files, Choose Files to Upload

Please upload your documents here:

Drag & Drop Files, Choose Files to Upload

Please upload your documents here

Drag & Drop Files, Choose Files to Upload

Please upload your documents here

Drag & Drop Files, Choose Files to Upload

- Step 1 of 5

I acknowledge Chelwood is a data controller for the purposes of this application.

Name of child (as it appears on their birth certificate) *

First

Last

Child's date of birth *

I am applying for my child to start in academic year: *

2026 - 2027 (Sept 2026 start)
2027 - 2028 (Sept 2027 start)
2027-2028 (Sept 2028 start)
A place as soon as possible

Please note, we only take children from the term after they turn 2 years of age (subject to a valid eligibility code or letter). Occasionally we have January places available. Please state if you need a January start.

WHAT TYPE OF PLACE ARE YOU LOOKING FOR?

We are looking for a *

2 year old place
3 or 4 year old place
Rising 3 place (child's birthday between 1st Sept and 31st Dec of the year you applying for

Please note, we take children from 2 years old (subject to a valid eligibility code or Lewisham eligibility letter). You can find more information about the places we offer on our website here https://chelwood.lewisham.sch.uk/our-offer/

Do you have a 2 year old free funding eligibility letter from the local authority? (for families on certain benefits)

Yes
No
I am going to apply

For further information about who is eligible to receive free funding for 2 year-olds, please visit https://www.gov.uk/help-with-childcare-costs/free-childcare-2-year-olds?utm_source=childcarechoices&utm_medium=microsite

Upload a copy of your 2 year old eligibility letter here

Drag & Drop Files, Choose Files to Upload

Do you have a 2 or 3 year old 30 hour working entitlement code

Yes
No
I am going to apply

Please provide your 11 digit 2 or 3 year old working entitlement code if you have one (this usually begins with a 5)

What type of place are you looking for? *

Our 2nd preference is for a

Please give reasons for your AM or PM preference as this will help us to allocate places.

MORE DETAILS ABOUT YOUR CHILD

Is your child: *

Male
Female

Is your child a twin? (if so, please complete a separate application for the other twin)

Child's country of birth *

Family religion or belief (optional)

Child's ethnicity *

Does your child have a sibling currently at Chelwood?

Name of sibling

Have you previously had a child at Chelwood?

Their name:

Which borough do you live in?

Distance from home to Chelwood (metres)

To be calculated by Chelwood

Child’s permanent home address (proof will be required) *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Proof of address can be one of the following: a current council tax bill, an energy bill within the last 3 months, a bank statement within the last 3 month.

Has your child ever been a 'looked after child' or had a child protection plan, or are they adopted? *

DETAILS OF PARENTS / CARERS

Details for 1st parent / carer

Name of 1st parent / carer *

First

Last

Mobile number *

Home phone

Email *

Address *

Address of 1st parent/carer *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Language(s) you speak at home *

Would you like an interpreter at your admissions meeting?

Details for 2nd parent / carer

Name of 2nd parent / carer

First

Last

Mobile number

Home phone

Address

Address of 2nd parent/carer

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Language(s) you speak at home *

Would you like an interpreter at your admissions meeting?

HEALTH INFORMATION

Doctor's practice

Health Visitor's name

Are any professionals involved with your child or family? *

Speech and language therapist
Hospital consultant
Social worker
Audiology
Portage
Other
None

Paragraph Text

Did your child have a 2 year check with a health visitor? *

Yes
No
Can't remember

Does your child have from any diagnosed medical conditions? *

Yes - please provide further details below
No

Has your child been immunised? *

Yes
No
Some

Does your child take any regular medication? *

Has your child had MMR vaccination? *

Yes
No
Don't know

Does your chid have any allergies? *

Yes - please give details below
No

Further information about medical conditions

Further information about allergies

Has your child previously attended any nurseries, childminders, play groups

Nursery
childminder
playgroup
day care
other
No

Details of settings attended, age and for how long

Documentation required

You will need to provide the following information to accompany your application. You can upload this information now, or provide it before your admissions meeting.

Proof of your child's date of birth - either a birth certificate or passport
Proof of funding (working parents code or eligibility letter)
Proof of parental responsibility - a copy of your child benefit letter (with your child's name on it) or a letter from a GP/hospital with the child's name on it
Proof of address (council tax bill, rent statement)

Please note: We do need to see the original copy of your child's birth certificate. Please upload a copy of the certificate here and once we offer you a place, bring the original into the office.

Proof of date of child's date of birth (please upload)

Drag & Drop Files, Choose Files to Upload

Proof of funding (working parents code or eligibility letter)

Drag & Drop Files, Choose Files to Upload

Proof or parental responsibility (please upload)

Drag & Drop Files, Choose Files to Upload

Proof of address (please upload)

Drag & Drop Files, Choose Files to Upload

Any additional information