Registration Test Registration Form (Salesforce) "*" indicates required fields Step 1 of 6 16% Child’s DetailsThis field is hidden when viewing the formRecord Type ID (School Identifier)*Child's first name*Leave blank if not born yetChild's surname*Please use parent’s surname if not born yetGenderSelectMaleFemaleNon-BinaryLeave blank if not born yetDate of birth* DD slash MM slash YYYY Is this an expected date of birth?* Yes No Right to ResidePlease note that the School is required to take steps to ascertain whether your child has permission to be in the UK and to study at the School.Please state your child's nationality:*SelectBritishAfghanAfrican-AmericanAlbanianAlgerianAmericanAndorranAngolanAnguillanArgentineArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBelarusianBelgianBelizeanBenineseBermudianBhutaneseBolivianBotswananBrazilianBritish Virgin IslanderBruneianBulgarianBurkinanBurmeseBurundianCambodianCameroonianCanadianCape VerdeanCayman IslanderCentral AfricanChadianChileanChineseCitizen of Antigua and BarbudaCitizen of Bosnia and HerzegovinaCitizen of Guinea-BissauCitizen of KiribatiCitizen of LiechtensteinCitizen of SeychellesCitizen of VanuatuColombianComoranCongoleseCook IslanderCosta RicanCroatianCubanCymraesCymroCypriotCzechDanishDjiboutianDominicanDutchEast TimoreseEcuadoreanEgyptianEmiratiEnglishEquatorial GuineanEritreanEstonianEthiopianFaroeseFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGibraltarianGreekGreenlandicGrenadianGuamanianGuatemalanGuineanGuyaneseHaitianHonduranHong KongerHungarianIcelandicIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhKenyanKittitianKoreanKosovanKuwaitiKyrgyzLaoLatvianLebaneseLiberianLibyanLithuanianLuxembourgerMacaneseMacedonianMalagasyMalawianMauritianMalaysianMaldivianMalianMalteseMarshalleseMartiniquaisMauritanianMexicanMicronesianMoldovanMonegasqueMongolianMontenegrinMontserratianMoroccanMosothoMozambicanNamibianNauruanNepaleseNew ZealanderNicaraguanNigerianNiueanNorthern IrishNorth KoreanNorwegianOmaniPakistaniPalauanPalestinianPanamanianPapua New GuineanParaguayanPeruvianPitcairn IslanderPolishPortuguesePrydeinigPuerto RicanQatariRomanianRussianRwandanSaint LucianSalvadoreanSammarineseSamoanSao TomeanSaudi ArabianScottishSenegaleseSerbianSierra LeoneanSingaporeanSlovaianSlovakSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSouth SudaneseSpanishSri LankanStatelessSt HelenianSudaneseSurinameseSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTogoleseTonganTrinidad and TobagoTrinidadianTristanianTunisianTurkishTurkmenTurks and Caicos IslanderTuvaluanUAEUgandanUkrainianUruguayanUzbekVenezuelanVietnameseVincentianWelshWest IndianYemeniZambianZimbabweanSeychelloisPlease choose your child’s nationality from the list above.Is your child a British or Irish citizen?*YesNoStudent visa type required*Child/StudentStudentBNOTier 1VisitorOther leave to remainWithdrawnBritishNot SetIf your child is not a British or Irish citizen but holds or will hold another immigration category that permits them to study at the School, including if they have been granted digital status under the UK's EU Settlement Scheme, please provide full details below:*Does your family use any additional languages? Please state which:Which nursery would you like to register for?*91-93 Princedale Road165 New King’s Road233 New King’s Road5 Kensington Place430 Fulham RoadHow many days a week would you like your child to attend?*3 days per week4 days per week5 days per weekWhich are your preferred sessions? Monday AM Monday PM Monday Full Day Tuesday AM Tuesday PM Tuesday Full Day Wednesday AM Wednesday PM Wednesday Full Day Thursday AM Thursday PM Thursday Full day Friday AM Friday PM Friday Full Day Is your child eligible for any of the following funding:*2 year old funding3 year old funding (15 hours)3 year old funding (30 hours)None of theseDoes your child have a sibling that attends or previously attended one of our nurseries?* Yes No When would you like your child to start nursery?* DD slash MM slash YYYY First Parent or Carer's DetailsFirst Parent or Carer's full name* DrMissMrMrsMsMxProfessor Prefix First Last First Parent or Carer's address* Street Address City Postcode Aland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian OceanBrunei DarussalamBulgariaBurkina FasoBurmaBurundiCHINACambodiaCameroonCanadaCape VerdeCape VerdeCayman IslandsCentral African RepublicChadChileChristmas IslandCoco(Keeling) IslandColumbiaComorosCongoCongo (DRC)Cook IslandsCosta RicaCroatia (Hrvatska)CubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGeorgiaGermanyGhanaGibraltarGrand CaymanGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHONG KONGHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJAPANJamaicaJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNIGERIANamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNiueNorfolk IslandNorwayOmanPakistanPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalQatarRUSSIAReunionRomaniaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaSão Tomé and PrincipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Island(British)Wallis and Futuna IslandsWestern SaharaYemenZambiaZimbabwe Country Contact informationFirst Parent or Carer's telephone number*First Parent or Carer's email address* Work detailsFirst Parent or Carer's work telephoneFirst Parent or Carer's work email address First Parent or Carer's occupationFirst Parent or Carer marital statusSelectMarriedCommon-law marriedSeparatedDivorcedWidowedNot marriedSecond Parent or Carer's DetailsAdd second parent Add second Parent Second Parent or Carer's full name DrMissMrMrsMsMx.Prof. Prefix First Last Second Parent or Carer's address Same as first parent Street Address City Postcode Aland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian OceanBrunei DarussalamBulgariaBurkina FasoBurmaBurundiCHINACambodiaCameroonCanadaCape VerdeCape VerdeCayman IslandsCentral African RepublicChadChileChristmas IslandCoco(Keeling) IslandColumbiaComorosCongoCongo (DRC)Cook IslandsCosta RicaCroatia (Hrvatska)CubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGeorgiaGermanyGhanaGibraltarGrand CaymanGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHONG KONGHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJAPANJamaicaJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMayotteMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNIGERIANamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNiueNorfolk IslandNorwayOmanPakistanPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalQatarRUSSIAReunionRomaniaRwandaSaint BarthelemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaSão Tomé and PrincipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Island(British)Wallis and Futuna IslandsWestern SaharaYemenZambiaZimbabwe Country Second Parent or Carer’s contact informationSecond Parent or Carer's telephone numberSecond Parent or Carer's email address Second Parent or Carer’s work detailsSecond Parent or Carer's work telephoneSecond Parent or Carer's work email address Second Parent or Carer's occupationSecond Parent or Carer marital statusSelectMarriedCommon-law marriedSeparatedDivorcedWidowedNot married Confidential InformationPlease complete this Confidential Information Form, if applicable, in order to assist us with making any special arrangements which are required for Nursery visits. Does your child have learning requirements or require any additional support?SelectYesNoDetails of additional support and learning requirementsAny medical conditions to declare?*SelectYesNoDetails of medical conditions*Any additional details How did you hear about us?* Word of mouth Google Social media Online advert Print advert daynurseries.co.uk Other Important informationUpdates*After you register your child, we would like to contact you occasionally with Nursery updates, as we believe this will help you make an informed choice about whether our Nursery is the right option for your child(ren).Please tick here to consent to us contacting you in this way. We will never sell your data to third parties. If you later change your mind, you can tell us by emailing the Nursery office. Yes, please do send me occasional updates. No, I’m not interested in hearing occasionally from the school. Consent*We will process your and your child’s personal information in accordance with our Privacy Notice for Parents, which is available at https://www.pippapopins.com/privacy-policy/ I agree to the privacy policy.Registration fee*A non-refundable payment of £250 is required today to register your child at our Nursery. Following confirmation that your registration has been accepted, we will require a deposit of £2,000 in advance of them starting with us. Please input your card details on the following page to pay the registration fee via our secure payment service provider. Price: NameThis field is for validation purposes and should be left unchanged. Δ