Monday to Friday: 8:40 AM — 15.20 PM
0208 004 5481
[email protected]

APPLICATION FORM

1. CHILDREN'S DETAILS

CHILD 1 DETAILS

Child's First Name
Field is required!
Field is required!
Child's Last Name
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Field is required!
Date of Birth
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Field is required!
Previous School
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Field is required!
  • Class you are applying for:
  • Nursery class AM (8:40 - 11:40AM)
  • Nursery class PM (12:20 - 3:20PM)
  • Reception
  • Year 1
  • Year 2
  • Year 3
  • Year 4
  • Year 5
  • Year 6
Class you are applying for:
Field is required!
Field is required!

CHILD 2 DETAILS

Child's First Name
Field is required!
Field is required!
Child's Last Name
Field is required!
Field is required!
Date of Birth
Field is required!
Field is required!
Previous School
Field is required!
Field is required!
  • Class you are applying for:
  • Nursery class AM (8:40 - 11:40 AM)
  • Nursery class PM (12:20 - 3:20 PM)
  • Reception
  • Year 1
  • Year 2
  • Year 3
  • Year 4
  • Year 5
  • Year 6
Class you are applying for:
Field is required!
Field is required!

CHILD 3 DETAILS

Child's First Name
Field is required!
Field is required!
Child's Last Name
Field is required!
Field is required!
Date of Birth
Field is required!
Field is required!
Previous School
Field is required!
Field is required!
  • Class you are applying for:
  • Nursery class AM (8:40 - 11:40 AM)
  • Nursery class PM (12:20 - 3:20 PM)
  • Reception
  • Year 1
  • Year 2
  • Year 3
  • Year 4
  • Year 5
  • Year 6
Class you are applying for:
Field is required!
Field is required!

Was your child/ren on the safeguarding/child protection register at their previous school?

Field is required!
Field is required!

2. PARENT/GUARDIAN DETAILS 1

Your First Name
Field is required!
Field is required!
Your Last Name
Field is required!
Field is required!
Your Address
Field is required!
Field is required!
Your Phonenumber
Field is required!
Field is required!
Your E-mail Address
Field is required!
Field is required!
Your Occupation
Field is required!
Field is required!

3. PARENTS/GUARDIANS DETAILS 2

Your First Name
Field is required!
Field is required!
Your Last Name
Field is required!
Field is required!
Your Address
Field is required!
Field is required!
Your Phonenumber
Field is required!
Field is required!
Your E-mail Address
Field is required!
Field is required!
Your Occupation
Field is required!
Field is required!

Why are you applying for a space at Unique Academy?

Why are you applying for a space at Unique Academy?
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Field is required!

Are you ready to accept a space immediately should you be accepted?

Field is required!
Field is required!

How did you hear about us?

Field is required!
Field is required!

Is your family involved with social services?

Field is required!
Field is required!

4. EARLY YEARS APPLICANTS ONLY

Are you applying for 30 hours funding?
Field is required!
Field is required!
If you're applying for 30 hours funding, please provide your voucher code (e.g. 500XXXXXXXX or 501XXXXXXXX)
Code
Field is required!
Field is required!
If you are not applicable for 30 hours funding are you willing to pay for additional hours?
Field is required!
Field is required!

5. DECLARATION

We have a non refundable administration fee of £100 if you are successfully offered a place into the school. This includes the provision of documents.

Please tick your agreement to pay the admissions fees
Field is required!
Field is required!

6. WITHDRAWAL POLICY

I will give one term's notice should I chose to withdraw my child (children) from the school. I understand that one term's fees will be due, and the school will undertake necessary measures to reclaim any fees which are due. Children must not stop attending the school during the withdrawal notice period.

Signature of Parent/Guardian:
Your Full Name
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Field is required!
Date:
Select a date
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Field is required!

7. I confirm that the information I have provided above is accurate and true.

By ticking the box, you confirm that all information provided by you regarding your child is accurate and true to the best of your knowledge. If any information provided is found to be false or misleading, Unique Academy reserves the right to terminate your child's enrollment at the school without refund or notice. It is your responsibility to ensure that all information provided is up-to-date and accurate.
Field is required!
Field is required!
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