Free School Meal Eligibility & Pupil Premium Application Form
Your completion of this form enables the school to check for Free School Meal Eligibility and also if additional money (Pupil Premium) can be claimed from the Government.

Free School Meals can be provided to pupils if parents/guardians meet the eligibility CRITERIA 1 below.
We urge you to complete this form even if your child does not take a school meal.

Pupil Premium is additional funding given to schools for pupils who have been registered as being entitled to Free School Meals (FSM) at any point in the last 6 years. Schools receive this funding to support their eligible pupils and narrow the attainment gap between them and their peers.  Other Pupil Premiums are available to the school if parents or guardians meet CRITERIA 2 below.

Further information about how the school spends its Pupil Premium can be found on the school website.

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Email *
Parent/Guardian 1
First Name *
Last Name *
Date of Birth *
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National Insurance Number or National Asylum Support Service (NASS) Number *
Parent/Guardian 2
First Name
Last Name
Date of Birth
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DD
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YYYY
National Insurance Number or National Asylum Support Service (NASS) Number
Please give names and classes for all your children at Stamford Green Primary School and Nursery *
Declaration
I confirm that the details supplied are correct and accurate. I understand that my personal information is held securely and agree that the school can only use the information provided to process my claim for Free School Meals and / or Pupil Premium by contacting Surrey County Council, who will check entitlement via a secure government website.

I understand that I am responsible for informing the school immediately if I stop receiving one of the qualifying benefits.

By signing this form I am confirming that I have read and fully understood the above declaration.

N.B. This form must be signed by the person who is in receipt of any of the qualifying benefit.

Signed Parent/Guardian 1 *
Date *
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YYYY
Signed Parent/Guardian 2
Date
MM
/
DD
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YYYY
A copy of your responses will be emailed to the address you provided.
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