Free school meals application form
Free school meals application form
Free school meals application form
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>Free</strong> School Meals Application Form<br />
Student and Pupil Support, 3 rd Floor, Laurence House, London, SE6 4RU<br />
Telephone 020 8314 6221 Email Pupil.Support@lewisham.gov.uk<br />
This <strong>form</strong> is to apply for free <strong>school</strong> <strong>meals</strong> at Lewisham <strong>school</strong>s. If your children attend <strong>school</strong> in another<br />
borough, apply to that borough for assistance. If your children attend an independent <strong>school</strong> or Academy apply<br />
directly to the <strong>school</strong>.<br />
OFFICE USE ONLY Reference no:<br />
Date received<br />
Previous <strong>form</strong><br />
A. PARENT / GUARDIAN DETAILS<br />
You Your partner<br />
Last name*<br />
First names*<br />
Title<br />
Date of birth*<br />
National insurance number* or<br />
NASS number<br />
Previous names<br />
Address<br />
Postcode<br />
Telephone number<br />
If the sections marked with a * are<br />
not complete we will not be able to<br />
check your entitlement.<br />
B. YOUR CHILDREN Give details of all the children in the family attending full time <strong>school</strong> up to the age of 18.<br />
First name Last name Date of birth<br />
Boy /<br />
Girl<br />
School<br />
Your relationship to<br />
this child<br />
C. DECLARATION<br />
I declare that the in<strong>form</strong>ation I have given in this <strong>form</strong> is true and complete and I undertake to in<strong>form</strong><br />
Lewisham if my entitlement to one of the qualifying benefits stops. I further authorise Lewisham to contact<br />
other sources as allowed by the law to verify my initial, and ongoing entitlement. I understand that the results<br />
of any free <strong>school</strong> lunch eligibility check may also be used to assess my entitlement to receive free <strong>school</strong> milk<br />
and hardship funds.<br />
I further authorise that the data on this <strong>form</strong> may be held on a computer system which has been registered in<br />
accordance with the Data Protection Act 1998 and may be shared with other local and national government<br />
agencies in order to facilitate the processing of this or other <strong>application</strong>s for assistance including Student<br />
Support and Housing Benefit.<br />
Signature Date<br />
fsm <strong>form</strong>.doc 1
D. DWP BENEFITS / INLAND REVENUE TAX CREDITS Which benefits / tax credits do you receive?<br />
Tick box<br />
Income support or Income-based Job Seeker’s Allowance (JSA)<br />
Income-related Employment Support Allowance (ESA)<br />
Child Tax Credit with no entitlement to Working Tax Credit and an annual income below £16,190<br />
Guarantee Element of Pension Credit<br />
Support under part VI of the Asylum Act 1999<br />
E. EQUAL OPPORTUNITIES MONITORING POLICY<br />
Lewisham Pupil Support wants to ensure that we continue to provide our benefits to those families in need<br />
from all areas of the community. You are not required to complete this section to receive assistance.<br />
Are you, the claimant, male or female? Male Female<br />
Do any of your children have a physical disability or Special Needs? Yes No<br />
Are you a single parent? Yes No<br />
Have you applied to Lewisham for free <strong>school</strong> <strong>meals</strong> before? Yes No<br />
How would you describe your ethnic origins? Please tick one of the boxes below.<br />
Asian Black White Mixed<br />
Bangladeshi African British Mixed ethnicity<br />
Indian Caribbean Irish<br />
Pakistani British Turkish<br />
Arab Other black Greek<br />
Chinese Other white<br />
Vietnamese<br />
Other Asian<br />
How to apply<br />
You can hand this <strong>form</strong> into any AccessPoint, your child’s <strong>school</strong> or post it to us.<br />
Schools will not issue a free meal until they receive a free meal authorisation from Lewisham. If you see an officer at<br />
AccessPoint at Catford or Downham they will issue you with an authorisation which you should take into your child’s<br />
<strong>school</strong>. If you post your <strong>form</strong> to us or hand it to your child’s <strong>school</strong> we will send a <strong>meals</strong> authorisation directly to the<br />
<strong>school</strong>. This will be valid from the date we receive your <strong>form</strong> but may take a day or more to arrive.<br />
If we are unable to confirm your entitlement to free <strong>school</strong> <strong>meals</strong> we will write to you to request additional<br />
in<strong>form</strong>ation.<br />
General in<strong>form</strong>ation<br />
This <strong>application</strong> lasts for one year. We will write to you to renew your <strong>application</strong> when this <strong>form</strong> is due to expire.<br />
You must let us know if your benefit stops or changes or you change address. If you children start a new <strong>school</strong>, that<br />
<strong>school</strong> will not issue free <strong>meals</strong> until they receive a <strong>meals</strong> authorisation.<br />
OFFICE USE ONLY Initial and date QA 1<br />
Hub check QA 2<br />
On list QA 3<br />
Schools notified Other<br />
fsm <strong>form</strong>.doc 2