College ID Number* Student name* Student date of birth* DD slash MM slash YYYY Contact number*Contact email* Enter Email Confirm Email Childcare and Provider detailsHow many children?*One childTwo childrenThree childrenFour childrenFive children1st child's name* 1st child's date of birth* DD slash MM slash YYYY 1st child's Childcare Provider name* 1st child's Childcare Provider address* Street Address City ZIP / Postal Code 1st child's Provider contact email* 1st child's Provider contact number*2nd child's name* 2nd child's date of birth* DD slash MM slash YYYY 2nd child's Childcare Provider name* 2nd child's Childcare Provider address* Street Address City ZIP / Postal Code 2nd child's Provider contact email* 2nd child's Provider contact number*3rd child's name* 3rd child's date of birth* DD slash MM slash YYYY 3rd child's Childcare Provider name* 3rd child's Childcare Provider address* Street Address City ZIP / Postal Code 3rd child's Provider contact email* 3rd child's Provider contact number*4th child's name* 4th child's date of birth* DD slash MM slash YYYY 4th child's Childcare Provider name* 4th child's Childcare Provider address* Street Address City ZIP / Postal Code 4th child's Provider contact email* 4th child's Provider contact number*5th child's name* 5th child's date of birth* DD slash MM slash YYYY 5th child's Childcare Provider name* 5th child's Childcare Provider address* Street Address City ZIP / Postal Code 5th child's Provider contact email* 5th child's Provider contact number*Birth Certificate upload*Please upload copies of your children's date of birth Drop files here or Select files Max. file size: 50 MB. Terms and Conditions*- I understand that childcare funding is only agreed when I have received written confirmation from the college - If you have a partner at home who can undertake childcare during your scheduled classes at Leicester College, then you will not be eligible for childcare funding. - Leicester College expect parents who chose to study; to select different timetabled courses. If you chose to study the same course at the same time, then you will not be eligible for childcare support - I agree that any Free Early Education Entitlement funding will be deducted from my allocation and not used in another setting. Any additional costs for lunches or extra activities must be paid by me as the parent/carer - Any change to timetable must be notified to a Welfare Adviser immediately - Any change of nursery/childminder needs to be discussed and agreed in advance with a Leicester College Welfare Adviser - I agree that I need to have any additional childcare agreed by a Leicester College Welfare Adviser (this includes childcare costs during placement). If you are commencing a placement then confirmation needs to be provided from your tutor regarding the start date of placement. - I agree to notify Leicester College if my child/ren stop attending the nursery / childminder or if I withdraw from my course. (Note: You may incur costs if you fail to do so.) I have read and understood the terms and conditionsDate signed* DD slash MM slash YYYY Student Signature*CAPTCHA
