Enquiry form

* Indicates required field

Child's Name *

First

Last

Address *

Is this address *

Home telephone number *

Email of parent 1 *

Is your child currently attending a playgroup/nursery/crèche or cared for by someone else? If Yes, please provide details in the 'Additional Information' box. *

Child's country of birth *

Child's nationality *

Gender *

Child's date of birth *

Parent 1 Name, and relationship to child *

Parent 1 mobile number *

Parent 1 date of birth *

Parent 2 Name, and relationship to child *

Parent 2 mobile number *

Address of parent 2 if different to the child's *

Parent 2 date of birth *

Is father's name on the birth certificate *

Language(s) spoken / heard at home *

Main carers National Insurance number *

I would like to apply for *

Funded part time place of 15 hours Funded full time place of 30 hours Extended hours (included top up hours during the core day, breakfast club and or after school club) A fee paying place as I am not eligible for a funded place

Reference number for funded 2 year old place for 15 hours *

Reference number for the funded 30 hour place for 3 and 4 year olds (DERN) *

How did you hear about Ethelred? *

Have you applied anywhere else? *

Yes No Not yet

Additional information / anything else you would like us to know about your child *

We do offer places for 2 year olds. Please visit this link to find out if you are eligible for 2 year old funding and also by visiting Lambeth Parent Portal.

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