Fillable GLASGOW CALEDONIAN UNIVERSITY CARER/NURSERY FORM (University of Aberdeen)

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GLASGOW CALEDONIAN UNIVERSITY CARER/NURSERY FORM (University of Aberdeen)

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GLASGOW CALEDONIAN UNIVERSITY
CARER/NURSERY FORM
This form is only valid if submitted as part of the completed Discretionary Fund Form
Academic Year 2020-21
SECTION A - MUST BE COMPLETED BY CARER/NURSERY
COMPLETION OF THIS SECTION BY THE STUDENT WILL RENDER THE APPLICATION INVALID
Name & Address of Carer/Nursery __________________________________________________________
__________________________________
_____________________________________________________
N
ame of Manager _________________________________ _ Tel No________________________________
A
re you a Registered Childcare Provider? Yes No If yes, Registration No.________________________
Please provide a copy of your registration certificate.
Unregistered Carers MUST submit proof of Address (e.g. household bill) with this form.
C
hild’s Name___________________________________________ Age__________________________
Child’s Name___________________________________________ Age__________________________
St
art date of childcare ___________________ for this academic trimester
Child’s Name
Child’s Name
Time (from – to)
No. Hours
Time (from – to)
No. Hours
Monday
Monday
Tuesday
Tuesday
Wednesday
Wednesday
Thursday
Thursday
Friday
Friday
No. of Hrs per week No. of Hrs per week
Cost per hour £ Cost per hour £
Weekly Cost £ Weekly Cost £
Total Weekly Cost £
If more than 2 children, please continue on separate sheet.
Trimester Cost = 15 weeks
Total Weekly cost x 15 A
£
Local Council or other contributory funding x 15 B
£
Balance A minus B
£
Verification of costs to be completed by Carer/Manager
I certify that the details and costs given above are correct and the information written in Section A has been completed by the
Nursary/Carer provider. I understand that Glasgow Caledonian University (GCU) will check the validity of the above
information and will contact me to confirm attendance of child(ren). I agree that I am bound to inform GCU of any changes
made to the childcare arrangements I have detailed on this form. GCU is the Data Controller for this information. Further
information on how personal data is used can be found at https://www.gcu.ac.uk/student/feesandfunding/privacynotice/
Name (Print)____________________________________ I understand and agree to the above (tick)
S
igned:____________________________________________ Date________________
0
0
0
0
SECTION B - TO BE COMPLETED BY STUDENT
Name of Student: _______________________________________________
Student ID No: ____________________________________________________
Course:________________________________________________ Year:________________
Tel. No: Home __________________________ Mobile_____________________________
Details of part-time employment: If variable, please give details of average shifts
Day
Shift times
Start time
Finish time
Monday
Tuesday
Wednesday
Thursday
Friday
I certify that the information overleaf is true and accurate, and I understand that a Funding Adviser will
check the validity of this information and will contact the Childcare Provider to confirm attendance of
my child(ren). I confirm that should my childcare arrangements change, I will inform the Funding Team
and I accept that I will be liable to repay to the University any overpayments made in connection to such
changes of circumstances.
S
igned_____________________________________________Date____________________
Please note:
• C
hildcare subsidy only covers a maximum of 15 weeks for Trimester 1 and 2 each. It does not cov
er
h
olidays or any meals provided for the child or childcare transport costs.
• Any subsequent applications e.g. Trimester 2, can only be considered if submitted along with
recei
pt/letter from Carer confirming payment for Trimester 1
• O
nly days timetabled to attend GCU or placement will be considered for an award from th
e
C
hildcare fund.
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GLASGOW CALEDONIAN UNIVERSITY CARERNURSERY FORM (University of Aberdeen)

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Completed 4 February 2021

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