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Home Information Form – Reception
Step
1
of
5
20%
Child's Details
Name
(Required)
First
Last
Date of Birth
(Required)
DD slash MM slash YYYY
Date of Entry into Reception
(Required)
DD slash MM slash YYYY
Nationality
(Required)
Religious Denomination
(Required)
Further Information
Has your child had their two year check and if so, were they deemed to have met the relevant developmental milestones? If not, please expand below.
(Required)
Please give details of your child's previous playgroup / nursery experience. Please give details of setting, sessions and experience.
(Required)
Are there any siblings? If yes please specify their ages.
(Required)
Does you child play happily with other children?
(Required)
Is your child happy to be left in the care of another adult and can they manage without you?
(Required)
Is there anything in particular to note about your child's birth and very early development?
(Required)
When did your child begin to walk and crawl?
(Required)
When did your child begin to form recognisable words and at what age did your child start to communicate in full sentences?
(Required)
Has your child received any form of speech therapy (SALT)? If yes, please give details.
(Required)
Is English your child's first language? Does your child speak any other languages at home?
(Required)
Does your child wear glasses?
(Required)
Yes
No
Has your child visited an optician prior to starting school?
(Required)
We recommend that children are seen before starting school.
Yes
No
Date of last Optician visit
(Required)
When were your child's teeth last examined? Please note any issues below.
(Required)
Has your child received a hearing test in the last 6 months? If yes, please give the date of the last hearing test. We recommend that all children are seen prior to starting school.
(Required)
Yes
No
Date of hearing test
(Required)
Further information
Children starting in The Nest and Reception are expected to be fully toilet trained (no nappies).
My child is toilet trained (no nappies).
(Required)
Yes
No
My child is fully independent going to the toilet.
(Required)
Yes
No
If you have indicated your child requires help sometimes, please give more details here. Or specify 'none' if not applicable.
(Required)
My child can undress/dress without help
(Required)
Yes
No
Requires help sometimes
Has your child established left or right handedness?
(Required)
Yes
No
Is there anything that makes your child worried or anxious?
(Required)
Do you or your child have any concerns about starting school?
(Required)
Is there anything else that you wish to let us know?
Have your contact details changed from those on the Registration Form? Please give details here if so.
Parent / Guardian confirmation
Name of Parent/Guardian completing the form
(Required)
Title
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First
Last
Email
(Required)
Personal Data
(Required)
In submitting your personal data via this form, you consent to being contacted via the details provided so that your enquiry can be responded to. A backup of your data will be held, but only authorised individuals will be able to access your data. If you would like your data to be removed, please email bgsec@biltongrange.co.uk.
To understand how we hold and use personal data, please review our privacy notice.
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