Confidential - The Exwick Ark Sign Up Form

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.
Thank you for your interest.
To send your details either complete this form, save as a PDF and send by email,
or print out this page, fill it in and return it to:

Mrs Harri Sharp
The Exwick Ark Pre-school,
46 Lavender Road,
Exwick
Exeter EX4 2PT

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 mornings 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 lunch 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 if you have one:

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last updated 20-06-2008