Application and eligibility form

Application and Eligibility Check Form

Please note this form is for those who are wanting to use a funded place within the City of York Council area.

If you are unsure where to find your nearest Family Information Service please visit the Family and Childcare Trust 'Find Your FIS' page.

You can also complete this form by contacting York Family Information Service on 01904 554444.

Only complete this form if you claim one or more of the benefits listed below.

Please complete this form in full for the main benefit claimant. Failure to provide all the information will prevent your application from being processed. Only use full legal names including middle names.

To be eligible you must be claiming one or more of the following benefits or meet one of the other criteria. Please tick all you are claiming.*
Main Benefit Claimant's Details
Child's Details
How did you find out about the funding?
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