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The School House.

Church Lane

West Wycombe

Bucks, HP14 3AH

Contact Rosie 01494 438996

Or email at wwpspg@gmail.com

Enrollment Form

Parent / Guardian Name *

First

Last

Contact Daytime Telephone Number *

Email *

Child 1 Name *

First

Last

Date of Birth *

Child 1 - Special Educational Needs Disabilities

Please let us know if your child has any SEND requirements (either diagnosed or suspected) they will require support with

Child 2 Name

First

Last

If applying for one than one child

Date of Birth

Child 2 - Special Educational Needs Disabilities

Please let us know if your child has any SEND requirements (either diagnosed or suspected) they will require support with

Start Date *

Sessions/ Days Required *

Monday 9am - 12pm
Monday 12pm - 3pm
Tuesday 9am - 12pm
Tuesday 12pm - 3pm
Wednesday 9am - 12pm
Wednesday 12pm - 3pm
Thursday 9am - 12pm
Thursday 12pm - 3pm
Friday 9am - 12pm
Friday 12pm - 3pm

Please Note: Child is required to enrol for 2 sessions, over 2 days minimum

Breakfast Club *

Breakfast Club Monday 8.30am - 9am
Breakfast Club Tuesday 8.30am - 9am
Breakfast Club Wednesday 8.30am - 9am
Breakfast Club Thursday 8.30am - 9am
Breakfast Club Friday 8.30am - 9am

Please Note: Spaces are limited

How will you be funding your childcare *

Self funding
Government Funded - Two-year-old Early Learning Funding
Government Funded - Universal entitlement for all 3- & 4-year-olds (15 hours per week)
Government Funded - Early Years Funded Entitlement for eligible children over the age of 9 months up to 4 year olds (30 hours per week for working parents)

Please Confirm *

I can confirm, I understand that Preschool is a multi level setting and my child can walk up and down stairs unaided safely.
I understand it is the parents’ responsibility to apply for the Eligibility code before the fixed deadlines 31st March, 31st August and 31st December and to reconfirm their codes every three months. If this is not completed my child’s funding code will expire and I will not be eligible to claim the funding. I will be responsible for paying for the sessions my child attends/

Email

Chartity Number 1033562 • Ofsted Number EY549960

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