Highgate Primary Family Centre - Toddler Stay and Play Financial Grant Application

1. Name of child *

2. Child's date of birth *

	MM/DD/YYYY

3. Full name of parent/carer completing this form *

4. Contact number for parent/carer *

5. Contact email for parent/carer *

6. Address of child *

7. Reason for applying for financial grant *

8. Do you receive any of the following financial supports? *

9. Do you have a child at Highgate Primary School? *

Yes
No

10. Name of child at Highgate Primary school (if applicable) *

The information provided above will only be used by the school to assess the application for the financial grant. It will not be used for any other purpose or shared with anyone outside of Highgate Primary School.

*

I confirm that I have read and understood the above.
I hereby declare that the information provided is true and accurate

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