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* 1. Student name (full name)

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* 2. I am happy to keep my child at home as they are safe to be left on their own and/or supervision is already in place.

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* 3. I will be able to meet all my child’s care needs without support from the school.

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* 4. I am happy to stay in communication with the school through phone calls and emails and will contact the school should we need support.

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* 5. I am a key worker and will need support from the school so that I can continue to attend work.

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* 6. I am a key worker and will need support from the school during the Easter break so that I can continue my work through the holiday period.

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* 7. Please tell us what jobs you and the other adults living at home do .
(Please note, the government hasn’t published the list yet so we are including anyone in the key worker category if you do a job that cannot be “closed down” for the next month. This includes NHS staff, emergency services, cleaners, maintenance, teachers, anyone in food or medicine industry, transport etc. This may change once government guidelines are published.)  

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* 8. My child is entitled to free school meals and I am worried that I won’t be able to feed them during a school closure.

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* 9. My child is Looked After/Child in Need/on a Child Protection Plan and I would like an opportunity to come in to school regularly so I can access support.

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* 10. My child is Looked After/Child in Need/on a Child Protection Plan and I would like a weekly phone call from someone at school.

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