Application for an Additional Year of Early Learning and Childcare

Please refer to the Additional Year of Early Learning and Childcare Policy and Procedure and to the Early Learning & Childcare (3 and 4 year old) provision and Wraparound Care Admission – Guidance Notes
If you would like to save your form before it is complete, you can do this from page 2 onwards. You would receive an e-mail with a link back to your form, which would then be available for up to 28 days. After 28 days your incomplete form would be deleted.
1. Child's details
1. Last name*
2. First name*
3. Middle name(s)
4. Date of birth*
5. Gender *
  
  Female
  
  Male
6. If the child is a twin, triplet etc. please indicate by writing the appropriate term.
7. Twin/triplet etc.
8. Child's address
  3. Selected address
    
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  4. Find address
    
    Where should it be collected from
    
    Postcode*
    
    Address
9. Please include area codes for landline numbers. No space separators please.
10. Home phone number
11. Mobile phone number
12. E-mail address*
13. We may use this e-mail address to contact you regarding this application.

Updated at 16 January 2017, 4:11PM

Address

Call our Customer Service Centre (CSC) 01506 280000

Email: customer.service@westlothian.gov.uk