Oxhey Early Years Centre Daycare Admissions

Oxhey Early Years Centre
Daycare Application Form
For further information or any queries please email finance@oeyc.herts.sch.uk
Child's Details
Child's Name *

First Name Middle Name Family Name
Date of Birth *

Day Month Year
Gender *

Male Female
Special Educational Needs *

Yes No
2 year funded *

Yes No
Please see Funding Information for Parents
Preferred Start Date
Have you been on a tour?

Yes No
Parent/Carer Information
Relationship to the Child *
eg Mother/Father/Carer/Stepmother/Father/Social Worker
Name *

Title First Name Last Name
Address *

House No, Street Name

Street Address Line 2

City County

Postcode
E-mail *
Telephone *
Employment Status (proof will be required) *

Working Studying Training Not working
Sessions for 2 - 3 Year Olds
Please indicate below which sessions you prefer. Minimum of 2 sessions per week over 2 days.
Do you require all year round or term time only? *

All year round Term time only
Are you entitled to free education and childcare for two year olds? This requires an eligibility code. *

Yes No

Full Days *

7.45am - 6.00pm

7.45am - 4.00pm

8.00am - 6.00pm

8.00am - 4.00pm

9.00am - 6.00pm

None

Monday

Tuesday

Wednesday

Thursday

Friday

Half Days *

8.00am - 1.00pm

1.00 - 6.00pm

None

Monday

Tuesday

Wednesday

Thursday

Friday

Will you be sharing funded hours with another provider *

Yes No
If you have any other information (eg can be flexible with days) please enter it here:
All children are entitled to 15 hours funding the term after their 3rd birthday. 30 hours funding is subject to eligibility and to children already doing the long days. Requesting additional sessions now is recommended, but is subject to availability at the time.
Request for additional sessions:
I confirm that the details above are correct to the best of my knowledge *

Yes
You will need to pay a non-refundable adminstration fee of £50 if we are able to offer you a place for fee paying provision. This is not required for children in receipt of two year old funding.

We also ask for a deposit of 4 weeks fees which will be returned to you against your child's final invoice.
In completing this application form you should refer to our Parent Privacy Notice. The personal information collected on this form will be processed to manage your application in accordance with this policy.
I have read and agree with the OEYC Parent Privacy Notice *

Yes
How did you hear about Oxhey Early Years Centre?

Facebook Word of Mouth Banner Advert in magazine Website Other
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Oxhey Early Years Centre