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 feel you meet one of the eligibility criteria.
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.