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School Closure Questionnaire
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* Indicates required question
Name of your child/ren
*
Your answer
Year Group/s
*
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Required
Name of parents and carers
*
Your answer
Emergency contact names and telephone numbers
*
Your answer
Reason for requiring a place
My child has an EHCP
My child has a social worker
I have read the new Critical Worker criteria and I consider myself to be a key worker and am not able to provide alternative arrangements
*
Yes
No
Required
If yes to the above, Name of role and organisation
Your answer
I consider that I have need of emergency care for my child for another reason (this will be considered on a case by case basis)
Your answer
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