Free School Meal and Pupil Premium Checker Form
This form is for parent/carer's of children in Nursery, Reception, Year 1 and Year 2 classes to apply for Pupil Premium and check free school meal eligibility.
Parent or Carer's FULL Name
*
First Name
Middle Name
Last Name
Parent or Carer's Date of Birth
*
-
Day
-
Month
Year
Date
Address
*
Street Address
Street Address Line 2
City
County
Postcode
Parent or Carer's National Insurance Number (eg AA123456B)
Parent or Carer's National Asylum Seeker Number (if applicable) (eg 1907/12345)
Contact Phone Number
*
-
Area Code
Phone Number
Parent or carer's Email address (for verification purposes)
*
example@example.com
Pupil's Name
*
First Name
Last Name
Pupil Date of Birth
*
-
Day
-
Month
Year
Date
I would like to add other siblings from St Anne's Infants' School & Nursery to this application:
*
Yes
No
Sibling 1 Pupil's Name
First Name
Last Name
Sibling 1 Pupil Date of Birth
-
Day
-
Month
Year
Date
Sibling 2 Pupil's Name (if applicable)
First Name
Last Name
Sibling 2 Pupil Date of Birth (if applicable)
-
Day
-
Month
Year
Date
Please tick the following:
*
I allow the use of the data in this form for thepurpose of checking whether my children are entitled to free school meals.
I allow the sharing of the above data with the local authority, for the purpose of providing freeschool meals if entitlement is confirmed.
I declare that I have parental responsibility for the child named on this form.
I consent to the school re-applying for free school meals in the future.
Date
*
-
Day
-
Month
Year
Date
Submit
Should be Empty: