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Application for free child care for 2 year olds
Application for free childcare for 2 year olds
Last Modified April 14, 2023
Download as PDF
pdf
Child details
Please complete details of your child
Name
First name
Last name
Address
Address Line 1
Address Line 2
City
County
Postcode
Country
Gender
Male
Female
Child's date of birth
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Applicants details
Details of parent / carer
Name
First name
Last name
Email
Phone
Parent / carer date of birth
National insurance number
How do you prefer us to reply to you?
Email
Letter
Would you also like us to send you an SMS text message?
Yes
No
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Income Criteria
Most applicants will want this option
Please tick relevant criteria
Working Tax Credits and have annual gross earnings no more than £16,190
Working Tax Credit ‘run-on’ – the payment you may receive for a further 4 weeks after they stop qualifying for Working Tax Credit
Child Tax Credit – provided you have an annual income of no more than £16,190
Income Support
Universal credit with maximum gross earnings of £15,400
Income-based Job Seeker’s Allowance
Income-related Employment or Support Allowance
Other criteria non income related
Please tick the relevant criteria
Child has left the care of a Local Authority through special guardianship or an adoption or residence order
The ‘Guaranteed’ Element of the State Pension Credit
Child has a current statement of Special Educational Needs (SEN)or is on an Education,Health and Care Plan (EHC )plan
Child of family with no recourse to public funds with a right to remain in the UK
Child of a subset of failed asylum seekers
Child of Zambrano Carers
Support under Part 6 of the Immigration and Asylum Act 1999
Child receives Disability Living Allowance
Child is looked after by a Local Authority
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Agreement and declaration
I certify that the information given on this form is correct to the best of my knowledge and belief. I understand that the council may check with the Department of Work and Pensions (DWP) and / or HM Revenue and Customs regarding my eligibility for free childcare for 2 year olds and the Early Years Pupil Premium for 3 and 4 year olds. If you wish to withdraw your consent to a check being undertaken for Early Years Pupil Premium (EYPP) in the future, you can inform your childcare provider or write/email Blackpool Council. We may need to use this information for enquiries under Section 29.3 of the Data Protection Act – amended 1998 – Detection and Prevention of a crime.*
Your data and privacy
Blackpool Council is the data controller for the personal information you have provided in this form. The council’s data protection officer can be contacted at DPA@blackpool.gov.uk. Your personal information will be used to contact the Department of Work Pensions DWP and / or HM Revenue and Customs regarding your eligibility for free childcare for 2 year olds. We will also use the information to maintain statistical records of how many childcare places are being accessed, but we will anonymise your information. We are allowed to ask for your personal information as the council has a statutory duty to provide up to 15 hours per week free entitlement to eligible families of 2 year olds. We will contact you to ask if you have a childcare place. We may share your information with children’s centres and health visitors to encourage take up and to facilitate the 2 Year Old Progress Check. We will share your information with others if we are required to do so by law. For further information about how Blackpool Council uses your personal information including your rights as a data subject, please see our website at www.blackpool.gov.uk/privacy
Please tick to confirm your agreement
Yes
No
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Submit
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