Application form – Chelwood Nursery School

Chelwood application form

- Step 1 of 5

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.

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: *

2023 - 2024
2024 - 2025
2025 - 2026

Please note, we take children from 2 years of age (subject to a valid eligibility code or letter) .

WHAT TYPE OF PLACE ARE YOU LOOKING FOR?

We are looking for a *

2 year old place
3 or 4 year old place
A place as soon as one becomes available

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://www.chelwood.lewisham.sch.uk/our-offer/

Do you have a 2 year old free funding eligibility letter from the local authority?

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

Click or drag a file to this area to upload.

What type of place are you looking for? *

Our 2nd preference is for a

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

MORE DETAILS ABOUT YOUR CHILD

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Is your child: *

Male
Female

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

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Child's country of birth *

Family religion or belief (optional)

Child's nationality *

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Does your child have a sibling currently at Chelwood?

Name of sibling

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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

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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

Field #60 (copy)

Mobile number

Home phone

Address

Address of 2nd parent/carer

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Layout (copy)

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

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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

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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

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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 your address - your latest council tax bill, or a utility bill 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:

Click or drag a file to this area to upload.

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Chelwood application form

WHAT TYPE OF PLACE ARE YOU LOOKING FOR?

MORE DETAILS ABOUT YOUR CHILD

DETAILS OF PARENTS / CARERS

Details for 1st parent / carer

Details for 2nd parent / carer

HEALTH INFORMATION

Documentation required

Contact us

Headteacher: Angelika Alleman

SENDCo: Michaela Loebner

Chelwood Walk, St Norbert Road, Brockley, SE4 2QQ

Phone: 020 7639 2514

admin@chelwood.lewisham.sch.uk

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