PLEASE READ THIS FORM IN FULL BEFORE COMPLETING IT

Transcription

1 Application Form PLEASE READ THIS FORM IN FULL BEFORE COMPLETING IT Please complete all sections of this form when applying for the grant. Please send your completed application form and relevant documentation to: New Childcare Business Grants Scheme, PO Box 894, Newport, South Wales, NP20 9NE. Claim Reference (for office use only) Eligibility Criteria You are eligible for a grant if you intend to start a NEW childcare business in the next 6 months and can demonstrate that you are taking steps towards this, or if you have already started a new childcare business within 12 months of receipt of your Ofsted or Childminding Agency (CMA) registration certificate. If you are eligible, you should apply now, to have your application assessed and approved. The grant will be paid when you have successfully registered with Ofsted or an alternative approved CMA, on the Early Years Register and / or the Childcare Register. A copy of your Ofsted/CMA registration certificate will be required before your grant is paid. If you are already registered with Ofsted but have not yet started trading, you should include a copy of your registration certificate and evidence that you intend to start your business in the next 6 months. If you are not yet registered with Ofsted or an approved alternative CMA, you should fill in this form to demonstrate the steps you are taking to set up your business. As a minimum you must have spoken to your local authority and registered for the necessary training courses before submitting this form. Once submitted and approved you will have 6 months to provide us with a copy of your Ofsted/CMA certificate. In all cases a copy of your registration certificate will be required before your grant is paid. NOTE: THESE START-UP GRANTS ARE TO ENCOURAGE THE ESTABLISHMENT OF NEW CHILDCARE BUSINESSES. IF YOU ARE ALREADY RUNNING A CHILDCARE BUSINESS OF ANY SORT AND YOU HAVE BEEN TRADING FOR LONGER THAN 12 MONTHS YOU ARE NOT ELIGIBLE FOR A GRANT. APPLICATIONS WILL BE ACCEPTED FOR NEW BUSINESSES WHO ARE OPERATING WITHIN THE FIRST 12 MONTHS OF THE RECEIPT OF THEIR OFSTED/CMA CERTIFICATE AND WHO HAVE NOT PREVIOUSLY RECEIVED A GRANT. PLEASE BE AWARE THAT SCHOOLS, EITHER INDEPENDENT, PRIVATE OR PUBLIC WHO ARE PLANNING TO START AN AFTER SHOOLS CLUB, BREAKFAST CLUB, OR OTHER CHILD CARE FACILITY ON SCHOOL PREMISES AND RUN BY THE SCHOOL ARE NOT ELIGIBLE TO APPLY FOR THIS GRANT.

2 In order to prevent delays when processing your application, please ensure that all sections are completed. If you have any queries or doubts regarding your eligibility, or require assistance in completing the form, please contact one of our operators prior to sending the form, on THIS APPLICATION MUST BE COMPLETED IN CAPITALS THROUGHOUT (All fields must be completed, except where indicated otherwise. Your claim will be returned to you if any information is missing.) Section 1: Personal details 1. Title: Mr Ms 2. Forename: Surname: 3. Address: Town/City: County: Post Code: 4. Date of Birth: 5. National Insurance Number: 6. _ 7. Daytime contact number: 8. Please provide your business premises address if different to the address given at 3 above? Address: County: Postcode: _ Section 2: About your business 9. If you are Ofsted/CMA registered, have you already started your childcare business? Yes: No: If so, you should send a copy of your certificate with this application form along with evidence that you intend to start your business soon. This evidence could be your business plan, evidence that you have secured clients, or evidence of discussions with your local authority. 10. Please give the expected start date of your business. 11. Please enter details of the type of childcare business you intend to start and the grant you are applying for: Childminder 500 Nursery: 1000 Out of School Club: 1000 Childcare on Domestic Premises: 1000 If you are starting a childminding business, do you intend to provide care for disabled children? If so, and you expect to incur additional expenditure in doing so, you will be eligible for a grant at the higher rate of Do you expect to incur additional expenditure to provide care for disabled children? Yes: No: To qualify for the higher rate payable grant please give details of what additional expenditure you expect to incur to provide care for disabled children. (You will be required to provide evidence of this expenditure to claim the enhanced grant). Details: 9a. If yes, please provide the date your business started trading: _ Please note that if you are already trading as a business you are only eligible for this grant if your business started trading within 12 months of receipt of your Ofsted/CMA certificate. 9b. If you are not yet trading, do you intend to start a childcare business in the next 6 months? Yes: No: 13. Where did you hear about this grant scheme?

3 Section 3: Your local authority Contacting your local authority should be your first step towards setting up a new childcare business. You should ask about the need for childcare provision in your area and the availability of the required training courses, together with what other support the local authority can offer you in setting up your business. Do not apply for this grant until you have contacted your local authority and booked yourself on the necessary training courses. Section 4: Your Ofsted/CMA Application details (Only complete this section if you are not already registered with either Ofsted or an alternative CMA) Payment of the grant is dependent on you successfully registering with either Ofsted or an alternative CMA. To do this, you will need to complete the following steps. However, don t wait to complete these steps before applying for a grant you may not be able to answer every question at this point. 14. The name of the local authority where the business will be set up: 15. Have you contacted your local authority? Yes: No: 16. Name of the person in your local authority family services department that you ve spoken to: Contact s name: Date you spoke to them: 17. You must have either completed or booked a place on your local authority approved childcare training course before you apply for your grant. Please enter the date when the course was/will be attended. 18. You must have either completed or booked a place on the relevant first aid course before you apply for your grant. A first aid certificate is a requirement for Ofsted/CMA registration. If caring for children under 5 years old this should be a paediatric first aid certificate. Please give the date when this course was / will be attended. 19. Have you applied for Ofsted/CMA registration? If so, please give the date when you did this. _ 20. Which register are you (or will you be) applying for? Early Years: Childcare: Both: 21. Have you applied for your Disclosure and Barring Service check? This will be required for you and for all other adults over 16 who reside at the premises where your business will be held and is mandatory for your Ofsted/CMA registration. If so, please give the date you applied: 22. How many adults will require DBS checks? 23. Have you completed your Health Check booklet section A&B? If so, please give the date when this was completed: 24. Have you contacted your GP to complete part C of the Health Check booklet? If so, date when this was completed?

4 Section 5: Claim Audits Your claim may be selected for a post-payment audit. If so we will require copies of your receipts and records which demonstrate the expenditure you incurred in getting registered with Ofsted or an alternative CMA. Such expenditure may include: Training costs, health check costs, Disclosure and Barring Service costs, Ofsted/CMA inspection costs, equipment costs, and other associated costs. Section 6: Payment Details You should complete this section now. However, no payment will be made until you have registered with Ofsted or an alternative CMA, on either the Early Years Register or the Childcare Register. You will need to submit a copy of your registration certificate to trigger the payment. Bank Account Name: Bank Name: Bank Sort Code: Bank account Number: Building Society Account Name: Building Society Name: Building Society Sort Code: Building Society Account Number: Building Society Roll Number: Section 7: Declaration I confirm that the details I have given here are correct to the best of my knowledge and that I know of no reason why I may be refused registration by Ofsted or an alternative approved CMA. I understand that providing false information will invalidate my application. I also understand that I will not receive a grant until I am Ofsted/CMA registered and sent in a copy of my registration certificate. I confirm that I am not currently running a childcare business, but I intend to do so once I am registered. I agree that my details may be shared with relevant statutory bodies. Signature: Date: Name: (Block Capitals): Section 8: Checklist In order to prevent delays when processing application forms, please ensure that: All of the questions have been answered (except where indicated otherwise) You have attached a copy of your Ofsted/CMA registration certificate (if you are already registered) The form is signed The form is dated You have completed the diversity questionnaire

5 Please send completed application forms with supporting documentation to the following address: Childcare Grant Scheme, PO Box 894, Newport, South Wales, NP20 9NE. Diversity Information The Government is keen to ensure that these grants are accessible to all. To help us monitor this, we would be grateful if you would fill in the form below. It will have no bearing on your application. Information provided will be treated as strictly confidential and will be used for statistical purposes only. It will not be published or used in any way which allows any individual to be identified. Gender: Male Female Are you married or in a civil partnership: Yes No Age: Prefer not to say What is your ethnicity? Ethnic origin categories are not about nationality, place of birth or citizenship. They are about the group to which you as an individual perceive you belong. Please indicate your ethnic origin by ticking the appropriate box; White: English Welsh Scottish Northern Irish Irish Gypsy or Irish Traveller Other White background Mixed/multiple ethnic groups: White and Black Caribbean White and Black African White and Asian Any other mixed background Asian/Asian British: Indian Pakistani Bangladeshi Chinese Any other Asian background Black/ African/ Caribbean/ Black British: African Caribbean Any other Black/African/Caribbean background Other ethnic group: Arab Any other ethnic group Prefer not to say Do you consider yourself to be disabled? Yes No Prefer not to say What is your sexual orientation? Heterosexual/straight Gay woman/lesbian Gay man Bisexual Other Prefer not to say What is your religion or belief? No religion Buddhist Christian Hindu Jewish Muslim Sikh Any other religion Prefer not to say