EARLY YEARS FUNDING

Please only complete this form if you have been asked to by Aspire Day Nursery Ltd - All funded children

It is you responsibility to inform us with if you are entitled to funded hours before the term starts. Please enter all the information correctly and enter your funding code. Failure to apply for funding, will result in full fee payments. The nursery is not responsible (or able to change) for any missed claim/ code periods.

Please ensure you monitor your emails from the gov account, as every term you will need to re-confirm your funding code. Failure to do so means you will fall into the ‘grace period’ potentially missing all funding claims.

Fees are calculated on the amount of hours we are open (how many days a week child attends over 51 weeks a year) with yearly funded hours taken away to give total chargeable hours.

Parent Authorisation Form Early Education Entitlements Autumn 2025 - Summer 2026

This form collects information from parents/carers to assess and process Early Education Entitlement (EEE) hours, eligibility for Early Years Pupil Premium (EYPP) and eligibility for Disability Access Fund (DAF). It is mandatory to complete a parent authorisation form for each setting your child attends for their EEE and thereafter complete a new form where there are changes to any details previously submitted.

This form must be completed, signed and returned to your childcare provider to confirm your entitlement access. If you wish to transfer your entitlement to a different childcare provider you must give four weeks’ written notice to your existing provider. Your child will not be able to access their early education entitlement at a new provider until the week following the end of the four week notice period. A false declaration may result in your early education entitlement being withdrawn.

Childs First name

Childs Last name

Birthday

Day

Month

Year

Number/house name

Street

2nd Line

Town

Post code

Sex

Female

Male

Child’s Ethnicity - Mandatory

Early Years Pupil Premium (EYPP) - is eligibility based and is paid to providers for provision of extra support for your child. EYPP is used to improve teaching and learning facilities and resources to impact positively on your child’s progress and development. Indicate below possible eligibility criteria you may meet.

In receipt of benefits, child tax credits, universal credits (please ensure parent details in section 3 are fully completed)

The child has left care under the subject of an adoption, special guardianship, child arrangement order (Please supply documentary evidence to your childcare provider. Provider to contact early years team to claim)

The child has been in local authority care for one day or more (Please supply documentary evidence to your childcare provider. Provider to contact early years team to claim)

Entitlement and parent details Please tick which entitlement you will be using. If your child is two years old and eligible for both entitlements, the maximum for each entitlement will be 15 hours giving a total of 30 hours.

Age

Working parent entitlement for children from 9 months old - 4 years (30 hours)

Entitlement for children from 2 years in families receiving additional forms of support

Universal Entitlement for 3-4 year olds (15 hours)

Enter the 11 digit code from HMRC here (required to access working family entitlement hours)

Details of parent/carer at child’s main residence - required to access working entitlement hours and EYPP

First name

Surname

Date of Birth

National Insurance Number

I consent for this data to be used to confirm eligibility for the following entitlements (please tick)

EYPP

Working family (30 hour children)

Families in receipt of additional forms of support

Days attended (7.30am to 6.30pm)

Monday

Tuesday

Wednesday

Thursday

Friday

Specify the total early education entitlement hours accessed at any other setting, including if within notice period to the provider named. Failure to do so may result in your entitlement being withdrawn.

Name of Provider

Total no of entitlement hours per week

Disability Access Fund (DAF)

If your child is currently in receipt of Disability Living Allowance the provider delivering your entitlement hours can claim an Disability Access Fund (DAF). DAF can be claimed once in a 12 month period and cannot be split between multiple providers within the 12 month period.

I understand the above statement and nominate the above provider to claim the Disability Access Fund for my child. I will provide a copy of my child’s current DLA award to confirm eligibility to the nursery.

SIGNATURE - DAF ONLY

Signature field is empty.

Parent, carer or guardian with legal responsibility declaration

I confirm I am only accessing early education entitlements at providers, in this or other Local Authorities, declared in section 5 I understand that the named provider will deliver the agreed hours free of charge. I have been shown and understand my providers free early education entitlement offer, including any voluntary charges for additional hours or services I understand that four calendar weeks' notice will be applied from the date I give written notice to end or amend the agreement. I will not be able to access the entitlement hours at any other provider until the week following the end date of the notice period It is my responsibility to meet any criteria or actions required to ensure the working entitlement code issued by HMRC remains valid Failure to renew the code within required timeframes will result in my working entitlement being withdrawn To claim the entitlement funding as agreed above on behalf of my child. I understand that the data collected in this form will be shared with my chosen provider, Achieving for Children and the Department for Education.

I confirm the information I have given in this form is true and accurate and I have read and understand the statement written above in section 6 of this form

Signature

Signature field is empty.

Print Name

Date

Day

Month

Year