Early Learning for Two-Year-Olds: Eligibility and Application
Early Years Service
Information/Application Form – Early Learning for Two-Year Olds
Please check your eligibility by contacting Family Information Service on 020 7364 6495 or Integrated Early Years Service on 020 7364 1553.
Section 1 – Child & Parent / Carer’s detailsPLEASE USE BLACK INK & BLOCK CAPITAL WHEN COMPLETING THE FORM
Child’s Name: YAMIN BOUHRARA | Date birth: 08-01-2019 | Gender F M * | |
Parent / Carer’s Name: TANIA NASCIMENTO | Date of birth: 11-01-1990 | ||
Relationship to child: | |||
Address: 11 D ABBEY ORCHARD STREET | Postcode:SW1P 2LW | ||
Landline: | Mobile: 07562335265 | ||
Email Address: yamin01@protonmail.Com | |||
Does your child have any additional needs (for example language, physical, social, medical, hearing, vision)? Yes No* | If yes, please provide further information below and/or attach any relevant report to assist your child’s placement, e.G. Early Help Assessment, Speech and Language Therapist report, Education, Health and Care Plan. If your child receives DLA, please include a copy of the confirmation letter from the DWP. | ||
National Insurance Number: SN 285170 C | National Asylum Seekers Service (NASS) number: (Please provide this number if you are an asylum seeking refugee family) | ||
THE ABOVE DETAILS MUST BE COMPLETED IN FULL FOR YOUR APPLICATION TO BE PROCESSED |
If you have confirmed your eligibility with Integrated Early Years Service or Family Information Service, please insert date and reference number: | |
Date: 19/11/2021 | Ref: (if applicable) |
Name of your local Children’s Centre: | |
Children’s Centre Registration Number: | Name of Family Support Worker/Referrer |
Email Address of referrer: | Contact number of referrer: |
Please complete below if you meet the extended criteria, please indicate which one applies by clicking on a box x
Criteria | x | Evidence Type | Evidence Inc x |
My child is looked after by a local council | Confirmation/statement from Social care Team to be provided | ||
My child has a current statement of special education needs (SEN) or an Education, Health and Care plan | Confirmation/statement from practitioner to be provided | ||
The child receives Disability Living Allowance | Confirmation of Eligibility letter from DWP to be provided |
| |
The child has left care under a special guardianship order, child arrangement order or adoption order | Confirmation from LA or Court Papers |
Section 2 – Ethnic Monitoring of Child
We will be using this data for statistical purposes. Please tick one box only. Please indicate by clicking on a grey box below x
Office use only | Definition | x | Office use only Code | Definition | x |
ABAN | Asian Bangladeshi | MOTH | Mixed Other | ||
AIND | Asian Indian | MWAS | Mixed White and Asian | ||
AOTH | Asian Other | MWBA | Mixed White and Black African | ||
APKN | Asian Pakistani | MWBC | Mixed White and Black Caribbean | ||
BAFR | Black African | NOBT | Not Obtained | ||
BSOM | Black African – Somali | OVIE | Other – Vietnamese | ||
BCRB | Black Caribbean | REFU | Refused |
| |
BOTH | Black Other | WIRT | Traveller of Irish Heritage | ||
CHNE | Chinese | WTUR | Turkish / Turkish Cypriot | ||
WGRE | Greek or Greek Cypriot | WBRI | White British | ||
WROM | Gypsy / Roma | WEUR | White European | ||
WIRI | Irish | WOTW | White Other – other | ||
OOEG | Other – Other please state: |
Section 3 – Early Education Provider Preference Details
Do you have a preferred early education provider (nursery, playgroup or childminder) or is your child already attending a childcare setting? Please provide details.
First choice | |
Second choice | |
Third choice |
Section 4 – Consent under General Data Protection Regulation (GDPR) and Terms and Conditions
I understand that my personal details will remain confidential to the Integrated Early Years Service and will be held by the Local Authority. I understand that the information I provide will only be shared with the setting where my child will be placed. I understand that I can ask to see information held about me at anytime. By completing the application form, I will be registered with children’s centres to help monitor and evaluate the outcomes for my child and family. I understand that making a false declaration will result in the withdrawal of the placement funding and that a fraudulent claim may result in action being taken against me. I understand that the London Borough of Tower Hamlets reserves the right to seek evidence of residency, receipt of benefits and other supporting documents. It is necessary for us to process your personal data (name, address, contact details) under: GDPR Article 6(1)(c) compliance with a legal obligation GDPR Article 9(2)(a) explicit consent Childcare Act 2006 Part 1 12(5)duty to provide information, advice and assistance I agree to this information being stored on a database in order that it is used to: Process my application for a funded place on the Early Learning for Two-Year Olds Scheme Assess eligibility for a funded childcare place Monitor and evaluate the outcomes for my child and family Support any transition planning if my child has additional needs I confirm that to the best of my knowledge the information I have provided is true. We will hold your information for as long as we are legally required to do so and to provide you with the necessary services. This is likely to be for 6 years after the case is closed. For further details, you can view our Retention Schedule on Tower Hamlets website. Your RightsYou can find out more about your rights on our Data Protection Page on the LBTH website. This includes details of your rights about automated decisions, such as the ranking of Housing Applications, and how to complain to the Information Commissioner. | |
Signature (Parent/Carer):TANIA NASCIMENTO | Date: 19/11/2021 |
Forms should be signed and sent by e-mail to:
early.Learning@towerhamlets.Gov.Uk
Or can be taken to your local SureStart Children’s Centre and forwarded by them.
For all enquiries call:
EL2 hotline: 020 7364 1553 or Family Information Service: 020 7364 6495
Integrated Early Years Service
Education and Partnerships,
5th Floor, Mulberry Place,
5 Clove Crescent, London E14 2BG
Eligibility Criteria for Early Learning for Two year olds
Please note that the income eligibility criteria are set by the government, not by LBTH. The extended criteria set by the government are detailed below.
Your child will be entitled to a place if you receive one of the following benefits:
- Universal Credit – if you and your partner are on a low income from work (this usually means a combined income of less than £15,400 a year after tax)
- Income Support
- income-based Jobseeker’s Allowance (JSA)
- income-related Employment and Support Allowance (ESA)
- tax credits and you have an annual income of under £16,190 before tax
- the guaranteed element of State Pension Credit
- support through part 6 of the Immigration and Asylum Act
- the Working Tax Credit 4-week run on (the payment you get when you stop qualifying for Working Tax Credit)
OR
- they are looked after by a local council
- they have a current statement of special education needs (SEN) or an education health and care (EHC) plan
- they get Disability Living Allowance
- they have left care under a special guardianship order, child arrangements order or adoption order
If your child is eligible, you can start claiming from the beginning of the term after they turn 2. The date you can claim will depend on when their birthday is.
Child’s birthday | When you can start to claim |
1 January to 31 March | the beginning of term on or after 1 April |
1 April to 31 August | the beginning of term on or after 1 September |
1 September to 31 December | the beginning of term on or after 1 January |