Is your family eligible for a free early education place for a 2 year old?

Please complete the form to see if you meet the criteria. All questions must be answered

Are you receiving one of the following: Required

If any of the last three options above apply to you:

Please call Walsall Families Information service for more information on your application on: 01922 653383

Do you have a National Insurance Number? Required
Do you have a National Asylum Seekers Support Number? Required
Is your child 2 years old, or going to be 2 in the next 3 months? Required

Details of your 2 year old

Required
Required
Gender Required
Date Of Birth Required
Europe/London
Do you have another child that you think is eligible for a free two year old place? Required

Your Details

Required
Required
Gender Required
Date Of Birth Required
Europe/London
Required
Required

Contact Details

Address Required
Required
Required
Do you have a partner living at the same address? Required

Agreement

I allow Walsall Council to assess my child's claim via a secure computer link with the Department for Education. I agree that Walsall Council can use the information I have provided to process my claim for a free childcare place and can contact other sources as allowed by law to verify my initial and continuing entitlement. I confirm that as far as I know the information I have given is correct

Please tick to confirm that you have read, understood and agree to the above statement Required
I would like details of eligible childcare settings that offer the free 2 year old

Data protection

The Information you provide will be held in line with the Data Protection Act 1998. It will be held confidentially and we will not pass it onto 3rd parties, unless we are legally required to do so (i.e. in cases of child protection) We will keep it on our database to process this and any future enquiries and may contact you from time to time with information you may find useful or to get feedback.

Please tick to confirm that you have read, understood and agree to the above statement Required
Please tick if you have older children in your care and would like to be contacted with information regarding their eligibility for Free School Meals
Would you like to hear from your local Children's Centre about the activities and support that they can offer you and your family?
How did you hear about Free Childcare for 2 year olds?

If you are happy that all your details are correct, please submit your claim. We will contact you in the next 5 working days to inform you of the outcome.

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