Monday to Friday: 8:45 AM — 15.15 PM
0208 004 5481
office@uniqueacademy.education

APPLICATION FORM

1. CHILD’S DETAILS

Child's First Name
Field is required!
Field is required!
Date of Birth
Field is required!
Field is required!
Child's Last Name
Field is required!
Field is required!
Previous School
Field is required!
Field is required!
  • Class you are applying for:
  • Toddler class AM
  • Toddler class PM
  • Nursery class AM
  • Nursery class PM
  • Reception
  • Year 1
  • Year 2
  • Year 3 (September 2022)
  • Year 4 (September 2022)
  • Year 5 (September 2023)
  • Year 6 (September 2023)
Class you are applying for:
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!

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!

4. NURSERY APPLICANTS ONLY

Are you applying for 15 hours?
Field is required!
Field is required!
Are you applying for 30 hours?
Field is required!
Field is required!

Due to the pandemic, we are suspending top up fees for the academic 2021 - 2022. They maybe reinstated in the future.

5. NURSERY APPLICANTS ONLY

2 YEAR OLD FUNDING

Are you eligible for 2 year old funding?

To check your eligibility for the 2 year old funding, please follow this link: https://fsd.hounslow.gov.uk/synergyweb/Enquiries/Citizen/EarlyYears.aspx

If yes, please provide us with a voucher code.

Voucher Code
Field is required!
Field is required!
If you are not eligible for the 2 year old funding, are you able to fund the place yourself?
Field is required!
Field is required!

6. OTHER INFORMATION

Lunch Arrangements
Field is required!
Field is required!
Travel Arrangements
Field is required!
Field is required!

7. NON-REFUNDABLE FEES PAYABLE IN THE APPLICATION PROCESS

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 and a free uniform.

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

8. 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
Field is required!
Field is required!
Date:
Select a date
Field is required!
Field is required!

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

Please tick to confirm that the information that you have given is accurate and true.
Field is required!
Field is required!

PLEASE BRING A COPY OF YOUR COUNCIL TAX BILL FOR THE CURRENT YEAR AS PROOF OF YOUR ADDRESS AND A COPY OF YOUR CHILD’S SHORT BIRTH CERTIFICATE IF YOU ARE INVITED FOR AN INTERVIEW.

Submit