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 and 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