Reception Visit Form

Reception Entry 2024 – Parent Information

Child’s name: *

Date of birth: *

Parent(s) name(s): *

Home address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Main contact number *

Email: *

School Details

Nursery School Name: (Please enter N/A if not applicable) *

School address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

School email address: *

Name of Head: *

Please upload your child's latest Nursery Report (if you do not have one please attach a blank sheet and we will request one directly) *

Click or drag files to this area to upload. You can upload up to 5 files.

Is English your child’s first language? *

Does your child speak any other languages? (Please specify)

Medical history

(Please include information on vision, hearing, allergies or any other medical conditions).

Are there any medical conditions that could affect your child in school? *

Yes (If Yes, Please Upload Copies of Any Relevant Reports below)
No

If Yes, Please specify below:

If Yes, Please Upload Copies of Any Relevant Reports

Click or drag files to this area to upload. You can upload up to 3 files.

Upload scans of the original documents. The preferred document format is PDF.

Is your child currently under the care of a medical specialist? *

Yes (If Yes, Please Upload Copies of Any Relevant Reports below)
No

If Yes, Please Upload Copies of Any Relevant Reports

Click or drag files to this area to upload. You can upload up to 3 files.

Upload scans of the original documents. The preferred document format is PDF.

Speech & Language/Occupational Therapy/EHCP/IEP

Does your child have or has seen any of the following *

A Speech and Language or Occupational Therapist
A Statement of Education Health and Care Plan
An Educational Psychologist or Specialist Teacher for an assessment
Receive additional support in his/her current school
An Individual Education Plan (IEP) or similar supporting document at his/her nursery school
None of the above

If yes, please specify below

Please Upload any reports/plans For The School’s Senco

Click or drag files to this area to upload. You can upload up to 4 files.

Is there anything about the pregnancy or birth that would be useful for the school to know?

Yes (If Yes, Please Upload this or Provide Details for the School’s Senco)
No

If yes, please specify below:

Is there any other information that it would be helpful for the school to know?

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

Reception Entry 2024 – Parent Information

School Details

Medical history

Speech & Language/Occupational Therapy/EHCP/IEP

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