Free Child Care

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Contact Details

1. Application for Free 2 Year Old Entitlement

1. The more information you include in this form, the faster we will be able to address your issue.

1. * Title Mr Mrs Miss Ms Cllr Dr Rev
2. * Forename
3. * Surname
4. * Please enter your postcode to look up your address
5. * Telephone
6. Alternative Contact Number
7. * Email

1. * Claimants Date of Birth
2. Please complete the below fields. If no number is provided, it may result in a delay in your application
3. * Will you be supplying a Nass Number (National Asylum Seeker Service Reference Number) or NI Number(National Insurance Number) NASS NI
4. * NASS/NI Number:
5. When selecting one of the below criteria, please read the notes relevant to the number selected
6. * Select which criteria you are applying under? 1. Receive Working Tax Credits and have annual gross earning of no more than £16,190 per year 1. Receive Child Tax Credit ONLY, Income below £16,190 1. Receive Income Support 1. Receive Income Based Job Seekers Allowance (JSA) 1. Receive Income Related Employment and Support Allowance (ESA) 1. Receive Guaranteed Element of State Pension Credit 1. Receive support through Part 6 of the Immigration and Asylum Act 1999 2. If the child has a current Statement of Special Educational Needs (SEN) or an Education, Health and Care Plan 3. If the child attracts Disability Living Allowance 4. If the child is looked after by their Local Authority 5. If the child has left care through a Special Guardianship Order or through an Adoption or Residence Order
7. 1. No action required. Information supplied will be checked with DWP databases
8. 2. No action required. Information supplied will be checked with Northumberland County Council SEN Team colleagues
9. 3. Please attach or post a copy of DLA award to Education Admin Service, Northumberland County Council, County Hall, Morpeth, NE61 2EF
10. 4. No action required. Information supplied will be checked with Northumberland County Council colleagues
11. 5. Please attach or post a copy of the relevant order to Education Admin Service, Northumberland County Council, County Hall, Morpeth, NE61 2EF
12. I understand that Northumberland County Council may share details I supply with my local children's centre and they may offer further support services
13. *

    1. Yes
    2. No
14. * Where did you hear about free childcare for 2 year olds? Facebook Health Visitor Leaflet Local children's centre Postcard Poster Twitter Other (give details below)
15. If you selected Other above, please give details

1. If relevant, please attach your documents by clicking the button below

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