KEY WORKER AND VULNERABLE CHILDREN - CHILDCARE DEMAND FROM 6TH JANUARY

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If you are a KEY WORKER or if you consider your child to be VULNERABLE, please complete this form giving the best detail possible. The form will be used to allocate places and to prioritise within this group if it becomes necessary.

PLEASE COMPLETE ONE FORM PER FAMILY.

CHILD(REN)'S NAME(S) *

I CONFIRM THAT I AM A KEY WORKER *

YES

NO - PLEASE DO NOT SUBMIT THIS FORM UNLESS YOUR CHILD IS VULNERABLE

DO YOU CONSIDER YOUR CHILD TO BE VULNERABLE? *

Yes, because of their special educational needs.

Yes, because they have an allocated social worker.

Yes, because they can't access home learning at home.

Yes, but for a reason not listed above.

No - my child is not vulnerable. (PLEASE DO NOT SUBMIT THIS FORM UNLESS YOU ARE A KEY WORKER)

PLEASE SELECT THE RELEVANT OPTION BELOW. Please note that all key workers are eligible for a place. This question will only be considered where demand is higher than our capacity. *

ONE PARENT IS A KEY WORKER

BOTH PARENTS ARE KEY WORKERS

KEY WORKER CATEGORY (Select multiple if more than one parent is a key worker). *

HEALTH AND SOCIAL CARE

EDUCATION AND CHILDCARE

KEY PUBLIC SERVICES

LOCAL AND NATIONAL GOVERNMENT

FOOD AND OTHER NECESSARY GOODS

PUBLIC SAFETY AND NATIONAL SECURITY

TRANSPORT

UTILITIES, COMMUNICATION AND FINANCIAL SERVICES

Required

CONSIDER THE FOLLOWING CHOICES BELOW AND SELECT THE MOST APPROPRIATE. *

I WILL NEED TO USE THE CHILDCARE IN SCHOOL AND I AM AWARE OF THE DAYS I REQUIRE EACH WEEK.

I WILL NEED TO USE THE CHILDCARE IN SCHOOL BUT I DON'T HAVE SET DAYS THAT I WILL NEED SUPPORT

AT THE MOMENT I DON'T NEED TO USE SCHOOL FOR CHILDCARE BUT MIGHT DO IN THE NEAR FUTURE.

I DON'T NEED A SPACE RESERVING NOW OR IN THE NEAR FUTURE. PLEASE ALLOCATE MY SPACE TO SOMEONE ELSE.

IF YOU SELECTED THE FIRST OPTION IN THE PREVIOUS QUESTION, PLEASE COMPLETE THIS QUESTION. WHICH DAYS WILL YOU REQUIRE SUPPORT DURING A TYPICAL WEEK.

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

FINALLY, HAVE YOU CONSIDERED ALL OTHER OPTIONS FOR ONGOING CHILDCARE? *

YES

NO - PLEASE EXPLORE THIS BEFORE SUBMITTING THE FORM.

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