Free school meals form

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• You must be in receipt of one of the benefits shown below to be eligible for free school meals for your child or children.
• Free school meals are available to eligible children that attend school within Wiltshire, on a fulltime basis. This includes nursery children (of compulsory school age) who attend school fulltime and sixth form students (but not college or Further Education level students). If you live in Wiltshire, but your child attends schools in another Local Authority area (e.g. Somerset, Hampshire or Swindon), you should apply via that Local Authority.
• We are now able to check entitlement to free school meals via a secure government website, which links to your benefit providers. However, if the eligibility checking service (ECS) has not been able to verify your entitlement, we will then need to contact you to ask for evidence to show you are currently in receipt of one of the eligible benefits.
• We cannot backdate claims. The date of entitlement is the date that we confirm your eligibility, using the ECS or paperwork supplied, and successfully process your application.

Fields marked * are required.

Benefit details

I confirm that I am currently in receipt of one, or more, of the benefits below. Please tick the box(es) to indicate which benefit(s) you are currently in receipt of. Without this information we cannot process your claim.

Income support

Income - based Job Seekers Allowance (not contribution based JSA)

Income - related Employment and Support Allowance (not contribution based ESA)

Support under Part VI of the Immigration and Asylum Act 1999 - National Asylum Seekers Support (NASS)

The guarantee element of the State Pension Credit

Child Tax Credit

(you must not be entitled to Working Tax Credit and have an annual income (as assessed by HM Revenue and Customs) that does not exceed £16,190 (April 2012))

Working Tax Credit 'run - on' - the payment you receive for a further four weeks after you stop qualifying for Working Tax Credit

If you currently receive Working Tax Credit (other than the ‘run-on’) you are not eligible to claim.

Universal Credit (provided you have an annual net earned income of no more than 7,400, as assessed by earnings from up to three of your most recent assessment periods)

Your details (Parent/Carer) please complete all sections as clearly as possible

Mr/Mrs/Miss/Ms *

First name *

Last name *

Address *

Postcode *

Date of birth *

Email

Telephone number

Mobile number

National insurance number *

Dependent details

Please complete details below for ALL dependant children that you wish to claim free school meals
for (they may go to different Wiltshire schools).

Child one

Child one - first name *

Child one - last name *

Child one - date of birth *

Child one - sex *  

Male

Female

Child one - name of school attended *

Your relationship to child one *

Child two

Child two - first name

Child two - last name

Child two - date of birth

Child two - sex  

Male

Female

Child two - name of school attended

Your relationship to child two

Child three

Child three - first name

Child three - last name

Child three - date of birth

Child three - sex  

Male

Female

Child three - name of school attended

Your relationship to child three

Child four

Child four - first name

Child four - last name

Child four - date of birth

Child four - sex  

Male

Female

Child four - name of school attended

Your relationship to child four

Child five

Child five - first name

Child five - last name

Child five - date of birth

Child five - sex  

Male

Female

Child five - name of school attended

Your relationship to child five

Child six

Child six - first name

Child six - last name

Child six - date of birth

Child six - sex  

Male

Female

Child six - name of school attended

Your relationship to child six

Terms and conditions

I certify that the information I have given is correct and I understand it is fraudulent to give
false information. Please choose... yes no

I agree that you will use the information provided to assess my current and ongoing eligibility to claim free school meals. I understand this information may be shared with organisations you work with to provide services to me. I understand that my entitlement to free school meals will continue only for as long as I receive one of the qualifying benefits. I agree to inform the free school meals team immediately if my benefit or tax credit entitlement changes or if I change my name or address. Please choose... yes no

End

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I have read and accept the terms of the privacy statement *

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Last updated: 13 August 2018