PARENT DETAILS. The information in this section is needed to make eligibility or validation checks for extended entitlement, Early Years Pupil Premium, or Disability Access Funding. Completing this section and signing this form gives us permission to use your details to make these checks. Your personal information will be kept by your provider in accordance with their Data Protection policies. Extended Entitlement The Local Authority will make checks throughout the year regarding your continued eligibility for the extended entitlement and notify your provider if your place is no longer funded. Early Years Pupil Premium (EYPP) Eligible children will be funded through the provider for the academic year. Regular checks for EYPP are made for families who qualify in year. If you qualify on an economic basis, information must be the eligible parent/carer’s details. Economic Check details Parent/Carer Details Applicant 1 Parent/Carer Details Applicant 2 Parent/carer’s title Parent/carer’s full name National Insurance or NASS No. Parent/carer’s Date of Birth Parent/carer’s telephone No. Address including post code (if different from child’s) Other qualifying criteria for EYPP Please tick and complete if you are able to let us know if the child meets one of these criteria. Your provider may ask to see legal documentation so that they can obtain the funding for your child. Currently in care, state which Local Authority Previously in care in England or Wales Has been adopted from care in England or Wales Has left care under a special guardianship order or residence order in England or Wales Disability Access Funding (DAF) If your child is in receipt of Disability Living Allowance (DLA) please select Yes below. Let your provider have a copy of the letter confirming the child’s entitlement to DLA in order to access DAF. If your child is attending more than one provider, you will need to nominate only one setting where you wish the DAF to go. Your provider will give you information about the DAF. Is your child in receipt of Disability Living Allowance? Yes / No If your child is eligible, who will be your Nominated Provider?
PARENT DETAILS. These details are required to determine eligibility for additional funding to support your child’s learning and development that may be provided to your chosen provider. This is called the Early Years Pupil Premium. For more information regarding how this funding is used please speak to your chosen provider. Parent/Carer 1 with Parental responsibility Title (Mr/Mrs/Miss etc) Forename Surname Relationship to child (Mother/ Father etc) National Insurance Number (or NASS number) Contact Number Date of Birth Relationship to child (Mother/ Father etc) National Insurance Number (or NASS number) Date of Birth Contact Number Surname
PARENT DETAILS. These details are required to determine eligibility for additional funding to support your child’s learning and development that may be provided to your chosen provider. This is called the Early Years Pupil Premium. For more information regarding how this funding is used please speak to your chosen provider. Title (Mr/Mrs/Miss etc) Forename Surname Relationship to child (Mother/ Father etc) National Insurance Number (or NASS number) Contact Number D.O.B Parent/Carer 2 with Parental responsibility Title (Mr/Mrs/Miss etc) Forename Surname Relationship to child (Mother/ Father etc) National Insurance Number (or NASS number) Contact Number D.O.B 4. ADDITIONAL DETAILS FOR 30 HOUR ENTITLEMENT 30 Hour Eligibility Code
