Critical Worker Status Questionnaire

Please complete this questionnaire to advise us if you qualify for critical worker provision in school for your child/ren due to the national lockdown. Please see the government guidance on what constitutes a critical worker.

https://www.gov.uk/government/publications/coronavirus-covid-19-maintaining-educational-provision

Completing this questionnaire will allow us to establish who is eligible to attend school. Please ensure that you read the guidance carefully: If your job does not fit in to any of the 'critical worker' categories stated, then please DO NOT complete this form.

The allocation of school places is for emergency childcare only where parent/carers are critical workers, cannot work from home and have no other childcare. We will contact you to confirm if your child is eligible to attend school

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* 1. What is your name?

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* 2. What is your telephone number?

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* 3. What is your email address?

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* 4. What is the name of your child/ren?

Child 1

Child 2

Child 3

Child 4

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* 5. What year is your child/ren in? (please tick all that apply)

Nursery

Reception

Year 1

Year 2

Year 3

Year 4

Year 5

Year 6

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* 6. Which sector does your job fall in to, please tick? (full list here; https://tinyurl.com/sqjewep)

Health and social care

Education and childcare

Local or National Government

Food and other necessary goods

Public safety & national security

Utilities, communication and financial services

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* 7. What is your job title and the company name/s and address/es of your employer/s?

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* 8. Please supply telephone numbers or email addresses for your employer. We may need to contact employers to verify your employment status.

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* 9. If there are 2 parent/carers living at your address please indicate if one or both of you are classed as critical workers. We may need to provide places only for children where both parent/carers are critical workers which will depend on numbers.

One parent

Both parents

Not applicable as only one parent at the address

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* 10. Can you please confirm which day's you would require a place at school? Please remember that if the children are able to remain at home, they should. School places should only be used as a last resort.

Monday

Tuesday

Wednesday

Thursday

Friday

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* 11. If eligable, would you require a critical worker place for your child/ren in the event of a main school closure? If you will be working from home, please consider whether your child/children still need to be in school.

Yes