Provider and attendance details Parents/legal guardians need to agree and complete a Registration form for each provider their child attends for funded early education, in order to ensure that funding is paid correctly. I am claiming the following number of funded early education hours for my child: universal Provider name(s) universal Term time Number of funded early education number of (T) or Please list all providers where your hours attended per day child is claiming funded universal funded stretched Mon Tue Wed Thu Fri Sat Sun hours and give details of the number of hours per (S) hours you are claiming per day/week. week 1) 2) 3) 4) universal Total number of funded hours per day Date my will start using funded universal hours at this provider Leaving date (if applicable) 30 Funded Childcare I am claiming the following number of funded early education hours for my child: extended Provider name(s) extended Total Term time Number of funded education number of (T) or Please list all providers where your hours attended per day child is claiming funded extended funded stretched Mon Tue Wed Thu Fri Sat Sun hours and give details of the number of hours per (S) hours you are claiming per day/week. week 1) 2) 3) 4) extended Total number of funded hours per day Date my child will start using funded extended hours at this provider Leaving date (if applicable) Ethnicity please tick the appropriate box to indicate your child’s ethnic group: – White Asian or Asian British British Indian Pakistani Traveller of Irish Heritage Bangladeshi Gypsy / Roma Chinese Any other White background Any other Asian background Mixed / Dual Background Black or Black British White and Black Caribbean Caribbean and Black African African and Asian Any other Black background Any other Mixed background Other ethnic group Prefer not to say Please tick one box only. Surrey County Council is required by the government to collect this information.
Provider and attendance details Parents/legal guardians need to agree and complete a Registration form for each provider their child attends for funded early education, in order to ensure that funding is paid correctly. I am claiming the following number of universal funded early education hours for my child: Provider name(s) Please list all providers where your child is claiming funded universal hours and give details of the number of hours you are claiming per day/week. Number of universal funded early education hours attended per day number of funded hours per week Term time (T) or stretched (S) Mon Tue Wed Thu Fri Sat Sun 1) 2) 3) 4) Total number of universal funded hours per day Date my will start using funded universal hours at this provider Leaving date (if applicable) 30 Funded Childcare I am claiming the following number of extended funded early education hours for my child: Provider name(s) Please list all providers where your child is claiming funded extended hours and give details of the number of hours you are claiming per day/week. Number of extended funded education hours attended per day Total number of funded hours per week Term time (T) or stretched (S) Mon Tue Wed Thu Fri Sat Sun 1) 2) 3) 4) Total number of extended funded hours per day Date my child will start using funded extended hours at this provider Leaving date (if applicable) Ethnicity – please tick the appropriate box to indicate your child’s ethnic group: White Asian or Asian British British Indian Pakistani Traveller of Irish Heritage Bangladeshi Gypsy / Roma Chinese Any other White background Any other Asian background Mixed / Dual Background Black or Black British White and Black Caribbean Caribbean and Black African African and Asian Any other Black background Any other Mixed background Other ethnic group Prefer not to say Please tick one box only. Surrey County Council is required by the government to collect this information.