How to Apply

Please complete the online application form below.
Once your application is submitted, we will send a confirmation email with information to submit a $50 payment.

For any further questions about the application process, please contact us on 1.441.232.4047 or email info@bloomfieldnursery.com and we will be happy to assist you during this exciting time!

Application Form (School Admission)

APPLICATION FORM

Student's Name:

First

Middle

Last

Prefers to be called:

Student's DoB:

Male/Female:

Place of Birth:

Nationality:

Has your child had any playground experience?

Has your child attended nursery or daycare before?

If so, name of school:

Are there any special medical, physical, developmental or emotional needs that the school/staff should be aware of?

Please give details:

Parents/Guardians

Parent/Guardian Name:

First

Last

Current Address:

Street Address

Street Address Line 2

City

Region

Postal / Zip Code

Country

Home Phone:

Work/Cell Phone:

Email:

Occupation:

Employer:

Parent/Guardian Name:

First

Last

Current Address:

Street Address

Street Address Line 2

City

Region

Postal / Zip Code

Country

Home Phone:

Work/Cell Phone:

Occupation:

Business/Employer:

With whom does the child live?

Siblings

Name:

Birthdate:

School Attending:

Name:

Birthdate:

School Attending:

Electronic signature

Please sign the form to confirm your admission application.

Email

Your admission confirmation will be sent via email.