Nursery Application

* Required

Children may enter Nursery the autumn term after their third birthday. Children enter Reception from the Nursery class in the September following their fourth birthday. Children may also join the school at this point, although priority in the allocation of places is given to children who are already attending Rupert House.

Please tick in the table below your preferences for your child's attendance in their first term.

Term of Entry*

MondayMorning 8.15-12 noonDay Full Time 8.15 - 15.15

TuesdayMorning 8.15-12 noonDay Full Time 8.15 - 15.15

WednesdayMorning 8.15-12 noonDay Full Time 8.15 - 15.15

ThursdayMorning 8.15-12 noonDay Full Time 8.15 - 15.15

FridayMorning 8.15-12 noonDay Full Time 8.15 - 15.15

Changes may be made to your choice of sessions at a later date if you should wish. The expectation is that the attendance of each child in Nursery will build up to a minimum of 3 full days per week by the summer term prior to starting Reception in September.

Child's surname:* Child's first and other names:* Name used daily, if different from above: Child's date of birth: required (dd/mm/yyyy)* Religion Nationality* Gender*

Is English your child's first language?*YesNo

Which other languages are spoken at home?* Name and address of current school/preschool/Nursery (if applicable): Post Code Name(s) and date of birth of any siblings:*

We/I enclose a cheque or have made a bank transfer for £75 as a non-refundable registration fee. For children entering the school in Year 1 and above a place will only be offered once your child has visited the school and, where appropriate, a satisfactory reference from the current school has been received and all obligations have been met. At that point, a deposit of £600 is required, which is held until your child moves to their next school. For children entering Nursery or Reception, the deposit is payable 18 months prior to entry.

Please select payable registration fee as appropriate:

Who has parental responsibility for the child?*MotherFatherJoint

Who has legal contact with the child?*MotherFatherJoint

Are parents jointly responsible for your child's education?YesNo

Father's Contact Details

Name* Address:* Home Telephone Number:* Work Telephone Number:* Mobile Number:* Email address:* Occupation

Mother's Contact Details

Name:* Address:* Home Telephone Number:* Work Telephone Number:* Mobile Number:* Email address:* Occupation

Please indicate with which parent the child normally resides :*

Alternative contact who could collect your child in an emergency:

Alternative contact 1:

Relationship to child:* Name:* Address:* Phone Number:*

Alternative contact 2:

Relationship to child:* Name* Address:* Phone Number:* Who is responsible for the payment of the bill?*Billing address, if different from home address: Please specify any learning difficulties or medical conditions your child may have. (You will be asked to complete a more detailed medical form once a place has been offered to your child):* Please specify any dietary requirements: Any other special requirements or information about your child of which the school should be aware: How did you first hear about Rupert House School?* Do you have any current or previous connections with the school?

The Friends of Rupert House is a volunteer parent body who organise social events within the school. Are happy for your details to be passed on to The Friends of Rupert House?*YesNo

We undertake to give a full term's notice in writing, before the withdrawal of our son/daughter and we understand that in the absence of such notice, the payment of a term's fees will be required by the Governors.'*I Agree

Signed

Father* Mother*

Rupert House is academically inspiring

Rupert House is co-educational

Rupert House is at the heart of Henley

Rupert House is active

Rupert House is for life

Nursery Application

Alternative contact 1:

Alternative contact 2:

Signed