12. Name of carer 2: 13. Telephone: (home) (work) (mobile) Are you 2) a current If Y, name of course and student number? 14. University of Bristol Y N student 15. Are you a current member (If carer 2 is UoB staff) Will you be eligible to join the of staff, please provide nursery salary sacrifice scheme for payment of nursery payroll number ( ) Y N fees? and name of faculty Y N N/A ____________________ 16. Expected course If you are a student, Undergraduate completion date or end of (please circle) contract (if fixed term Postgraduate staff) dd/mm/yyyy 17. Will you be a UoB staff Student Further information (e.g. your start date): member or student when Y N your child will start at the Staff nursery? Y N 18. Names and dates of birth of other children in family living at same address 19. I would like to apply for a nursery place to start from (dd/mm/yyyy) 20. Please indicate your nursery requirements in the table below (Note: Please indicate in the comments box if your requirements are flexible, e.g. any 3 days, no half days or Monday plus any other day, can be half days etc.) DAY AM LUNCH PM COMMENTS Monday Tuesday Wednesday Thursday Friday 21. Please tick your intended Full Year University Term Only Holidays Only usage of the nursery: Option only available to student parents 22. I declare the information on Your signature: Date: this form to be correct to the best of my knowledge:
12. Name of carer 2: 13. Telephone: (home) (work) (mobile) 14. Are you 2) a current University of Bristol student Y N If Y, name of course and student number? 15. Are you a current member of staff, please provide payroll number ( ) and name of faculty ____________________ Y N (If carer 2 is UoB staff) Will you be eligible to join the nursery salary sacrifice scheme for payment of nursery fees? Y N N/A 16. Expected course completion date or end of contract (if fixed term staff) dd/mm/yyyy If you are a student, (please circle) Undergraduate Postgraduate 17. Will you be a UoB staff member or student when your child will start at the nursery? Student Y N Staff Y N Further information (e.g. your start date): 18. Names and dates of birth of other children in family living at same address 19. I would like to apply for a nursery place to start from (dd/mm/yyyy) 20. Please indicate your nursery requirements in the table below (Note: Please indicate in the comments box if your requirements are flexible, e.g. any 3 days, no half days or Monday plus any other day, can be half days etc.) DAY AM LUNCH PM COMMENTS Monday Tuesday Wednesday Thursday Friday 21. Please tick your intended usage of the nursery: Full Year University Term Only Option only available to student parents Holidays Only 22. I declare the information on this form to be correct to the best of my knowledge: Your signature: Date:
Application%20form%20(NEW%20Final)_DD.docx