Revenues and Benefits
Free School Meals Application Form
You can apply for free school meals if you and your child live in the borough. You must get one of the
benefits listed overleaf and receive child benefit for the child you are responsible for.
your child gets a free school meal the school will get additional funding known as a pupil premium.
This money helps the school improve the education they provide.
To apply, fill in and post this form to us at the following address: Revenues and Benefits, RBC, PO
Box 490, Rochdale, OL16 9AJ.
You and your partner
First Name
Last Name
Date of
National Insurance or
NASS Number
Date your
benefit started
Your dependent children list all your children
First Name
Last Name
Male or Female
Date started
Your Address Postcode
Phone Number Email Address
I or we declare the information given on this form is correct and complete.
I or we understand that if the information given is incorrect or incomplete, you may take action against me
or us. I or we understand that you may check the information given on this form.
I or we know that if my or our circumstances change after I or we make this claim then I or we must tell you.
Signature of parent or guardian: Date:
click to sign
click to edit
Qualifying benefits
To get free school meals for your child, you or your partner must get one of the following
Income Support (IS).
Income-Based Jobseekers Allowance (IBJSA).
An Income-Related Employment and Support Allowance.
Support under part VI of the Immigration and Asylum Act 1999.
Child Tax Credit (provided you aren't entitled to Working Tax Credit) and have an income
t doesn't exceed the current year’s level.
The Guaranteed element of State Pension Credit.
Working Tax Credit during the 4-week period immediately after your employment finished.
Universal Credit. (from 1 April 2018 your net earnings must not exceed £7400 per year for
you and any partner)
You do not need to provide proof of your qualifying benefit as we will check entitlement via a
secure government website.
Children who get Income Support, income-based Job Seekers Allowance or income-related
Employment Support Allowance in their own right can also apply for free school meals.
ther help is available for pupils aged 16-19 in full-time education from the Local Education
If your child is struggling with the costs of learning they should speak to student services at their
school, college or training provider for more information.
Or contact Positive Steps free on 0800 195 8528
iversal Infant Free School Meals
From September 2014 all children in reception, year 1 and year 2 in state-funded schools in
England are eligible for Universal Infant Free School Meals. This includes academies, free
schools, pupil referral units and alternative provision as well as maintained schools.
They are available regardless of their parent’s or guardian’s income. Please contact your child's
school if you want them to receive a Universal Infant Free School Meal.
unds - If we award free school meals for a period of time you have paid for, you must
contact the school for a refund.
This form can be returned by post to Revenues & Benefits, PO Box 490, Rochdale OL16 9AJ
Or hand it in at one of our Customer Service Centres at: Number One Riverside, Smith St,
Rochdale, OL16 1XU. Middleton Library, Long St, Middleton, M24 6DU. Heywood Library, Lance
Corporal Stephen Shaw MC Way, Heywood, OL10 1LL.
or more information on Free School Meals you can:
Phone us on: 0300 303 8870 Monday to Friday, 8am to 6pm
Or visit our website:
Find out how we use your personal information at