Early Adopter Communities: evaluability assessment

Appendix E: EAC application/registration forms

Note: To view the images on this page at a larger size, please open the PDF that can be found under Supporting Documents.

Clackmannanshire

Application forms are not included as they are different for each provider.

Dundee

Glasgow

EAC application form

Glasgow City Council

Free Or Partially Funded School-Aged Childcare

Current Families receiving support

The Scottish Government is continuing with its plan to develop a system of School-Aged Childcare (SAC) that will be available and affordable for all eligible families and free for the most vulnerable.

Glasgow City Council's Education Department received a grant from the Scottish Government to support the costs of School Aged Childcare for low-income families who were attending identified Early Adopter Services within Ward Areas, Drumchapel Anniesland, East Centre , Southside Central and Calton from 1^st April 23 to 31^st March 24.

We are pleased to advise that we can extend this funded support in the interim until the schools return on the 14 August 2024 to existing families already receiving support, if they meet at least one of the Key Priority Family Indicators and also the set low-income criteria.

If you would like to be considered for the continuation of this funded support, we require you to complete an updated application form.

We have attached the updated application form to this communication. Once complete please return it to: [redacted] or your School Aged Childcare Provider.

If you would like to discuss your application, please don’t hesitate to get in touch with the Team by either emailing: [redacted] or call [redacted].

Further assistance with paying for childcare costs can be accessed here: https://www.childcarechoices.gov.uk/ and Funded early learning and childcare - mygov.scot

SAC Application 24-25 – existing families only - 1^st April 24

Glasgow City Council

School-Aged Childcare Support

Part 1

To be considered for the extended School-Aged Childcare Funded Support, you must be able to select at least 1 box in each of the criteria 1 to 4.

Please either put an x or tick in the box. If you are unable to complete the application digitally, we can accept paper copies complete by hand. We are more than happy to assist you in the completion of the application form.

Criteria 1.

Your child must attend one of the School-Aged Childcare Services taking part in the Early Adopter Project. Currently these are:

[redacted]:

Yes

Criteria 2.

• You’re a parent of at least one child under 16 years old: Yes
• You’re a kinship carer of at least one child under 16 years old: Yes

Criteria 3.

You fall within one of the priority family types:

• Lone-parent families
• minority ethnic familie
• families with a disabled adult or child
• families with a younger mother (under 25
• families with a child under one
• Larger families (three + children)
• Kinship Care Family: Yes

Criteria 4.

• You are entitled/in receipt of Free School Meals and not in employment: Yes
• You are entitled/in receipt of a School Clothing Grant and not receiving the childcare element of support from Universal Credit or Working Tax Credits: Yes
• Household earnings up to £26884 and not receiving the childcare element of support from Universal Credit/Working Tax Credit: Yes
• Kinship Care Family: Yes

If you are unsure if you meet the FSM/CG eligibility criteria please refer to the link for further information: https://www.glasgow.gov.uk/schoolsandlearning

Glasgow City Council

School-Aged Childcare

Application Form

Please Complete In Block Capitals

Part 2 – Tell us about you as the parent/guardian.

First name(s):

Last name :

National Insurance number

Address

Postcode:

How will we contact you?

Your phone number

Is this phone a:

mobile

landline

I do not have a phone number I can give you

Your email address

If you’re helping to fill out this form as a friend or relative, put the details of the person who is applying on this page.

Pattern of Children Attending School Aged Childcare / Sessions and Days

We need to know about the children attending the School Aged Childcare Provider and the number of days and sessions. This allows us to determine how much funded support we can offer. Please tick the box that applies to you.

Name of the School Aged Child Care Service they are attending:

Start Date:

Is this holiday provision only during the school term

Is this Term Time Only

Is this Summer provision only

Is this all year

Days of Attendance - Holiday provision during school term only :

Monday

Tuesday

Wednesday

Thursday

Friday

Days of Attendance - Term Time only:

Monday

Tuesday

Wednesday

Thursday

Friday

Days of Attendance - Summer provision only:

Monday

Tuesday

Wednesday

Thursday

Friday

Days of Attendance - All Year:

Monday

Tuesday

Wednesday

Thursday

Friday

Details of Children Attending the School Aged Child Care Service (SAC)

If you have more than three children attending and run out of space, you can add the details of other children in the box below.

1.

First name(s)

Last name

Date of birth D D M M YYYY

Is this child named on either you or your partner’s Child Tax Credit, Child Benefit, Universal Credit or Pension Credit claim, Kinship Care Agreement?

Yes

No

2.

First name(s)

Last name

Date of birth D D M M YYYY

Is this child named on either you or your partner’s Child Tax Credit, Child Benefit, Universal Credit or Pension Credit claim, Kinship Care Agreement?

Yes

No

3.

First name(s)

Last name

Date of birth D D M M YYYY

Is this child named on either you or your partner’s Child Tax Credit, Child Benefit, Universal Credit or Pension Credit claim, Kinship Care Agreement?

Yes

No

Additional Children Details:

How did you hear about the SAC support:

This lets us know how we can improve our engagement with families.

GFIS Website

School

SAC provider

Other Please specify

Would you like to take part in further engagement to allow us to understand how best to support family needs?

Yes

No

If not, why?

Do you receive the Scottish Child payment:

Yes

No

If not, why?

Eligible families and carers can find out more and apply online at www.mygov.scot/scottish-child-payment or by calling Social Security Scotland on free on 0800 182 2222.

Things you need to agree on before you submit your application form.

By signing this application, you agree to the following statements:

As far as I know and believe, I declare that the information I have given in this form is correct and complete.

I understand that I may be breaking the law and could be prosecuted if I provide details that are not correct and complete.

I agree to update Glasgow City Council by emailing [redacted] and the School Aged Childcare provider straight away if there are any changes to the details of my circumstances that I have given in this form.

This could be if:

I’m no longer looking after a child.

My financial circumstances have changed.

The child no longer attends the SAC provider.

I understand that if I do not report these changes:

I may be breaking the law.

It may affect my ongoing support.

I may be prosecuted.

Support may be reduced if I receive too much.

If I am acting on behalf of an entitled individual, I agree to be liable to pay Glasgow City Council the value of any assistance given in error, unless that error is neither my fault nor the kind of error that a person acting on an individual’s behalf could reasonably be expected to notice.

Your signature:

Date D D M M YYYY

If you’re filling in this form on behalf of someone who cannot manage their own affairs, or if you’re helping a friend or family member to fill out the form. We’d like you to give us your details.

First name(s)

Last name

Company or organisation name:

Address

Postcode

Contact Number:

Please now return the complete application for consideration/approval to [redacted] or direct to your SAC provider.

For information on how we use your data please refer to the following link: https://www.goglasgow.org.uk/ResourceItems/Visit/2550

For other support available to Glasgow families please scan the QR codes below.

Inverclyde