Date

Name of Parent(s) * (required)

If other, please advise

Address * (required)

Email Address * (required)

Alternative email address * (required)

Daytime Telephone Number * (required)

Secondary Telephone Number

Course or Department * (required)

Name of Child (If known) * (required)

Date of Birth (Or EDD) * (required)

Preferred Start Date * (required)

Privacy notice

This data on this form will be used to register your interest in a place for your child in the University Nursery. This data is used for our reference purposes only and will not be disclosed to any third party. This form will be destroyed when your child leaves the nursery.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.