All information contained in this form will be treated in the strictest confidence

APPLICATION FOR A NURSERY PLACE AT:

FULL NAME OF CHILD:

Date Of Birth / Expected Date Of Birth (dd/mm/yyyy):

GENDER:

NAME(S) OF PARENT(S):

ADDRESS:

POSTCODE:

HOME TEL No:

WORK TEL No:

MOBILE NUMBERS:

E-MAIL ADDRESS:

DO YOU HAVE LEGAL RESPONSIBILITY FOR THE CHILD?:

Yes

RELATIONSHIP(S) TO CHILD:

IS THERE ANYTHING ELSE THAT YOU FEEL WE SHOULD KNOW ABOUT YOUR APPLICATION FOR YOUR CHILD?

EXPECTED ATTENDANCE REQUIRED FOR CHILD:

Attendance	Hours Required
	From	To
Monday
Tuesday
Wednesday
Thursday
Friday
Weekly Totals

ANTICIPATED START DATE REQUIRED:

PROVISIONAL MONTHLY FEE: (see Terms)

REGISTRATION FEE: (£50.00 required with all new applications)

I confirm the above details are accurate, and that I have read and accept the Terms & Conditions by which care is provided for my child. I confirm that I have parental responsibility for the child named above.

Name:

Before we can process your application, we need you to complete our Direct Debit form. On submission of your application, a printable direct debit form will be generated for you to keep. If you you would prefer to complete a paper version of the application and direct debit forms, please click on the link below.

No fees will be debited from your account until one month before your child's confirmed start date in nursery. A minimum notice of 10 working days will also be given of the amount and date of your first fee payment.
All the normal Direct Debit safeguards and guarantees apply. No changes in the amount, date or frequency to be debited can be made without notifying you at least 10 working days in advance of your account being debited. In the event of any error, you are entitled to an immediate refund from your bank or building society. You have the right to cancel a Direct Debit instruction at any time simply by writing to your bank or building society with a copy to us.

In order to set up your Direct Debit Instruction on-line you will need to provide the information as detailed in the Direct Debit Form below. (your cheque book contains all the bank details that you require).

If you are not the account holder, if it is a business requiring more than one signature you need to complete a hard copy, or if you would rather complete a hard copy; please click here to download a paper version of the direct debit form and click here for a paper version of the application form to complete and post to us. If you are unable to print, please contact us by e-mail at or telephone 01763 247474 and we will post you a paper Direct Debit Instruction form along with an application form.

If you complete the Direct Debit Instruction online the details of the instruction will be confirmed to you immediately by email (please ensure the email address you enter is correct). If you complete a paper version of the Direct Debit Instruction, the details will be sent to you no later than 10 Working days before the first collection.

The company name which will appear on your bank statement against the Direct Debit will be 'Sunhill Daycare.’

Please fill in the whole form including the official box to make a direct debit application to:

SUNHILL DAYCARE (EUROPE) LIMITED
PO Box 157 Royston SG8 9WY

Instruction to your Bank or Building Society to pay by Direct Debit

Name(s) Account Holder(s):

Branch sort code

Branch/Building Society account number
Name and full postal address of you Bank or Building Society
To: The Manager Bank or Building Society

Address
Postcode

FOR SUNHILL DAYCARE (EUROPE) LIMITED USE ONLY

This is not part of the instruction to your bank or buiding society.

Child's name:

Instruction to Bank or Building Society
Please pay Sunhill Daycare (Europe) Limited Direct Debits from the account detailed in the instruction subject to the safeguards assured by the Direct Debit Guarantee. I understand that this Direct Debit will remain with Sunhill Daycare (Europe) Limited and if so, details will be passed electonically to my Bank or Building Society.

I agree

Date 08/02/2012

Banks and Building Societies may not accept Direct Debit Instructions for some types of account

Please now click ‘Submit’ to go to the next screen to pay £50.00 registration fee by credit or debit card and to print a full copy of your Direct Debit Instruction.

After completing registration you will also be asked to print two copies of your Application Form in pdf format, one for your records and one which must be signed and handed into your nursery when your child starts.
Thank you for registering your child with Sunhill Daycare'

The Direct Debit Guarantee

This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits.
If there are any changes to the amount, date or frequency of your Direct Debit, Sunhill Daycare (Europe) Limited will notify you seven working days in advance of your account being debited or as otherwise agreed. If you request Sunhill Daycare (Europe) Limited to collect a payment, confirmation of the amount and date will be given to you at the time of the request
If an error is made in the payment of your Direct Debit by Sunhill Daycare (Europe) Limited or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society.
If you receive a refund you are not entitled to, you must pay it back when Sunhill Daycare (Europe) Limited asks you to.

You can cancel a Direct Debit at any time by simply contacting your bank or building society. Written confirmation may be required. Please also notify us.

Click here to open a printable version of our Direct Debit Guarantee in a new window