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The Exwick Ark Sign Up Form

This form is just for you to express your interest in requesting a place for a child at The Exwick Ark.
We will recive this form as an email and contact you in a few days to discuss your request.
Thank you for your interest.
To send your details either complete this form and click the button at the end to send by email,
or print out this page, fill it in and return it to:

Mrs Harri Sharp
The Exwick Ark Pre-school
Exwick Parish Hall
Station Road
Exwick
Exeter EX4 2AA

admin@exwickarkpreschool.com
Request for a place at the Exwick Ark.
Name of child:

Your name:

Name of parent(s) /guardian(s):(use the return key to move to a new line)

Address of parent(s) /guardian(s): (use the return key to move to a new line)

Is this the same address as the child? YES   NO
If not please enter the address where the child lives:


Day time contact phone number for parent /guardian:


Date of Birth of Child:


Gender: MALE   FEMALE

Date you wish your child to start at the Exwick Ark:
September-December term   / January-March Term   / April-July term   / Other time
Other start date (please specify)

Which breakfast clubs you would prefer your child to attend The Exwick Ark?:
Monday / Tuesday / Wednesday / Thursday / Friday 

Which mornings you would prefer your child to attend The Exwick Ark?:
Monday / Tuesday / Wednesday / Thursday / Friday 

Which lunch clubs you would prefer your child to attend The Exwick Ark?:
Monday / Tuesday / Wednesday / Thursday / Friday 

Which afternoons you would prefer your child to attend The Exwick Ark?:
Monday / Tuesday / Wednesday / Thursday / Friday 

Which late birds clubs you would prefer your child to attend The Exwick Ark?:
Monday / Tuesday / Wednesday / Thursday / Friday 

We will endeavour to meet your preferred sessions but cannot guarantee them. Please let us know if you work or study and need particular sessions (use the other information box).



Please provide your e-mail address to recieve a copy of this form:




The Exwick Ark Pre-school, Copyright 2009.
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last updated 28-09-07