Form

First name*

Last name*

Email*

Parent / Carer 1 National Insurance Number*

Date of birth*

WE will not be able to check if you're eligible to receive the funding you specify without your date of birth

Day/Month/Year

Home Local Authority

School Attending*

Term

to which the funding applies

Type of Early Years Funding*

Please specify which type of funding you're funding code applies to. Note that 3-4 year old 15 hours funding is still a universal benefit and so no funding code is required.

15 Hour Funding Code

30 Hour Funding Code

Termly or All year Round*

Please note that funded hours apply 38 weeks a year, so if you want the provision to be spread all year round, we have to pro rate your funded hours - 30 hours / week becomes 22; 15 hours / week becomes 11. If you are term time only, you will not be registered to attend during half terms and school holidays - our holiday camp / club rates will apply, for which you can pay via tax free childcare if you prefer.

Term only

All Year Round

Fully Funded or Curricula Surcharge*

The school reserves the right to select which sessions fully funded children aged 3-5 years are given due to limited availability. Those who pay the curricula surcharge to access the extra curricula programme in clubs and outings will be given first option on places across the week.

Fully Funded

Curricula Surcharge