Application for Free Nursery Admission

Please complete the form below to apply for admission


Ysgol Hen Heol / Old Road School

Pennaeth / Headteacher

Mrs Non Neave


Old Road, Llanelli SA15 3HW Tel 01554 773822


Application for Admission to the Cylch Meithrin / Nursery Class


Part A. Parent(s)/Guardian(s)/Carer’s information.




Parent/Guardian (please specify)








Current Address

Previous Address





Post Code:


Length of time at this address:

Length of time at this address:

Home Tel No:


Work Tel No:



Part B. Pupil Information


Name of Child

Male /


Date of


Present School

Dates Attended








Yes / No

Is the child looked after by the Local Authority?

( If Yes, please attach details of the Social Worker, Local Authority and contact details )


Is the child subject to a statement of Special Educational Needs?



The attendance of an older brother or sister

(Please give names and dates of birth of older children)



Date of Birth


Date of Birth













Request start date for my child





Signature of Parent/Guardian:                     Date :


_______________________________             _______________________


Please return this form either to the Headteacher or e-mail to


Download this as a PDF