Application for Care to Learn

This application is for help to subsidise childcare costs for eligible learners aged 16-19.

Prior to completion of this form, you must have arranged a place for your child with an Ofsted registered childcare provider. If you will be using more than one childcare provider, a separate form must be completed for each provider.

Once you have completed this form, the college will contact your childcare provider for confirmation of their fees. When your application has been assessed, you and your childcare provider will receive notification of the outcome via email.

Learner Details

Student ID Number

Name*

Forename Surname

Date of Birth*

Home Address

Street Address Address Line 2 City ZIP / Postal Code

Contact Number*

Email*

Childcare Support Required

Child 1 Name*

Date of Birth*

Start date of childcare

Childcare sessions required for the days you attend college:

Child 2 Name

Date of Birth

Start date of childcare

Childcare sessions required for the days you attend college:

Adding additional child

True

Child 3 Name

Date of Birth

Start date of childcare

Childcare sessions required for the days you attend college:

Evidence of Child/ Children

Evidence of Child Benefit, Child Tax Credit or your child’s birth certificate is required for all children you are claiming childcare subsidy for. Please attach a copy of one of the following:- • Child Benefit letter • Child Tax Credit letter • Birth Certificate. If you wish to provide any other supporting documentation please upload it here.

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, doc, docx, xls, xlsx, rtf, txt, csv, otf, Max. file size: 10 MB, Max. files: 100.

Childcare Provider Details

Chlildcare Provider Name*

Address*

Street Address Address Line 2 City ZIP / Postal Code

Contact Number*

Email Address*

Terms and Conditions

Please read the Care to Learn Terms and Conditions carefully. If there are any points requiring clarification, please contact Student Services on 01772 225656.

Learner Declaration and Consent

Please read the Care to Learn Terms and Conditions carefully. If there are any points requiring clarification, please contact Student Services on 01772 225656.

I agree to the privacy terms and conditions and the college’s privacy policy.*

I confirm I have read and understood the Care to Learn Terms and Conditions*

I give consent for the college to contact my childcare provider as necessary.*