HOW Nurseries Registration Form Please complete the registration form below so that we can add you to our Nursery waiting list. * indicates required Email Address * Parent/Carers Name * Child’s Name * Address * Address Line 2 City State/Province/Region Postal / Zip Code CountryAlbaniaAlgeriaAndorraAngolaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaCongoCroatiaCyprusCzech RepublicDenmarkDjiboutiEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGuamGuineaGuinea-BissauGuyanaHondurasHong KongHungaryIcelandIndiaIndonesiaIrelandIsraelItalyJapanJordanKazakhstanKenyaKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMauritaniaMexicoMoldova, Republic ofMonacoMongoliaMoroccoMozambiqueNamibiaNepalNetherlandsNetherlands AntillesNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPanamaParaguayPeruPhilippinesPolandPortugalQatarReunionRomaniaRussiaRwandaSamoa (Independent)Saudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSomaliaSouth AfricaSouth KoreaSpainSri LankaSurinameSwazilandSwedenSwitzerlandTaiwanTanzaniaThailandTogoTunisiaTurkiyeTurkmenistanUgandaUkraineUnited Arab EmiratesUruguayUSAUzbekistanVatican City State (Holy See)VenezuelaVietnamVirgin Islands (British)YemenZambiaZimbabweAntigua And BarbudaAnguillaAmerican SamoaArubaBrunei DarussalamBouvet IslandCook IslandsChristmas IslandDominican RepublicWestern SaharaFalkland IslandsFaroe IslandsGrenadaFrench GuianaGibraltarGreenlandGuadeloupeGuatemalaHaitiJamaicaKiribatiComorosSaint Kitts and NevisSaint LuciaMarshall IslandsMacauMartiniqueMauritiusNew CaledoniaNorfolk IslandNauruNiuePapua New GuineaPitcairnPalauSolomon IslandsSvalbard and Jan Mayen IslandsSan MarinoTongaTimor-LesteTrinidad and TobagoTuvaluSaint Vincent and the GrenadinesVirgin Islands (U.S.)VanuatuMayotteMyanmarSao Tome and PrincipeSouth Georgia and the South Sandwich IslandsTajikistanUnited KingdomCosta RicaGuernseyNorth KoreaAfghanistanCote D’IvoireCubaFrench PolynesiaIranIraqLibyaPalestineSyriaAaland IslandsTurks & Caicos IslandsJersey (Channel Islands)DominicaMontenegroSudanMontserratCuracaoSint MaartenSouth SudanRepublic of KosovoCongo, Democratic Republic of theIsle of ManSaint MartinBonaire, Saint Eustatius and SabaSerbia Phone Number * Child’s date of birth * / /( dd / mm / yyyy ) Child’s Age When do you want your child to start nursery? * / /( dd / mm / yyyy ) How many hours childcare do you require? *2 full days3 full days4 full days5 full days3 half day sessionsAnother combination (please specify below) Another combination of hours Will you be accessing funding for childcare? No 2 year old working entitlement 2 year old play to learn funding 3/4 year old 15 hours universal funding 3/4 year old 30 hours working entitlement /* real people should not fill this in and expect good things – do not remove this or risk form bot signups */
