AL-QUBA Primary School

Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam

Would you like to send your child to our proposed Free School:

Yes, I would definitely include this new school in the choices for my child if I could

Maybe, I would need more information

No, I'm satisfied with our local education provision

Would you like to be updated on our progress? (Please include your email address and any contact information that you would like so that we can keep you updated on our progress!) :

	Yes
	No

Key stage	Year	Age Range	Number of Children *
N/A	Pre-School	2-3
KS1	Reception 1 & 2	4-7
KS2	3 to 6	7-11

Full Name: *		Email Address : *
Address:
postcode: *		phone Number:

Additional Comments? (Essentially, tell us why your family/community needs this school) - (Max Length 500 Characters)

Would you be interested in joining the campaign or assisting the school in any capacity? (Please describe any potential any ideas) - (Max Length 500 Characters)