Childs Name:

Date of Birth:

FemaleMaleUnknown

Setting: N/AWisbechMarchCorbyPeterborough

Change Type: N/AFoodChange of addressNursery daysNursery sessions // timesNursery sessions // day requirements

Requested Childcare Hours:

Monday: —Please choose an option—None0800 – 18000800 – 14000800 – 16000900 – 15000900 – 17001300 – 1800

Tuesday: —Please choose an option—None0800 – 18000800 – 14000800 – 16000900 – 15000900 – 17001300 – 1800

Wednesday: —Please choose an option—None0800 – 18000800 – 14000800 – 16000900 – 15000900 – 17001300 – 1800

Thursday: —Please choose an option—None0800 – 18000800 – 14000800 – 16000900 – 15000900 – 17001300 – 1800

Friday: —Please choose an option—None0800 – 18000800 – 14000800 – 16000900 – 15000900 – 17001300 – 1800

Bolt-Ons:

Proposed Change of Hours Start Date:

Method of Payment : N/AOnlineCardChildcareVouchersFunded ONLYTax Free Section - Monthly

Voucher/Funding Code :

Weekly Meals

Are you wanting Lunch, Tea or Both (Food Bundle)?

N/A

Lunch

Tea

Food Bundle

Which days do you want your child to have hot meals?

- Monday

- Tuesday

- Wednesday

- Thursday

- Friday

Does your child have any Food Allergies Or Food Intolerances? N/AYesNoUnknown

If Yes, then please inform enter details here

Your Details:

Parent/Carer/Legal Guardian 1:

Parent/Carer/Legal Guardian 2:

Address:

Post Code:

Telephone:

Email: