Preliminary Application Form

Please Select which services you are applying for *

After School Collection Morning Breakfast and Escort to School Holiday Playscheme Beanstalk Climbers 2-3/4 EYF

FATHER, MOTHER, CARER OR GUARDIANS DETAILS

THE REASON YOU NEED CHILDCARE

Choose Any *

I am working full-time I am working part-time I am studying full-time I am studying part-time

OTHER INFORMATION ABOUT YOUR CHILD

OTHER AGENCIES OR SUPPORT WORKERS INVOLVED IN YOUR CHILD-S CARE

YOUR CHILDS MEDICAL NEEDS

Does your child suffer from any medical condition that we need to be aware of? (e.g. asthma, diabetes, epilepsy, obesity, sickle cell etc). *

Yes No

Your child educational and behavioural needs

CAS processes information about members of CASP, applicants, children and other individuals for purposes of the administration and promotion of the organisation, the effective provision of child protection and welfare services.
Agreement to CASP processing some specified classes of personal data is condition of acceptance of a child into any of CASP’s services.
I consent to CASP processing and disclosing relevant personal data as set out above, including the processing of sensitive personal data.

My Full Name *

Date --/--/---- *

Time *

Preliminary Application Form

Please complete the form in full

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