Worcestershire County Council

Application for Free School Meals

The information you provide will be used for administering Free School Meal applications, which are processed using an automated decision making tool. We store this information for as long as you remain eligible plus 4 years, after which it will be securely disposed of. Please see our Privacy Policy for further information.
Before completing this application form, please read the following notes:
1.
If you receive any of these benefits then you may be entitled to Free School Meals:
Universal Credit provided they have an annual net earned income not exceeding £7,400 (£616.67 per month)
Income Support
Income-based Jobseeker's Allowance
Income-related Employment and Support Allowance
Support under Part 6 of the Immigration and Asylum Act 1999
The guarantee element of Pension Credit
Child Tax Credit, provided you are not also entitled to Working Tax Credit and have an annual gross income of no more than £16,190, as assessed by HMRC
Working Tax Credit run-on-paid for 4 weeks after you stop qualifying for Working Tax
2.
You MUST provide all the information we have requested so that we can undertake a benefit check against the relevant benefit departments. Please list all of your children on this form, even if they attend different schools. If we cannot confirm your entitlement through this process we will contact you to provide paper proof of the benefit you receive.
3.
If your child/ren are eligible to a free school meal they have the option of not taking this up but every valid claim will assist your child/ren’s school as it enables them to  access the governments pupil premium fund.
4.
We will send written notification to both you and your child/ren's school with the date provision starts. The date of entitlement starts when we receive a valid application and the eligibility is confirmed. Your claim cannot be backdated and will be reviewed on a regular basis. We will not notify you on any applications made for Key stage 1 pupils qualifying under the Universal Infant Free School Meal provision. This detail will be held at the school. 
5.
Your child/ren will continue to receive Free School Meals until the end of the Universal Credit rollout period. This will apply even if your earnings rise above the new threshold or if you stop being entitled to Universal Credit. The rollout period is currently scheduled to end in March 2022. Once Universal Credit is fully rolled out, your child will keep their free school meals until the end of their current phase of education i.e. primary or secondary.
Proxy Section
Please tick if you are filling in this form on behalf of the claimant
Parent/Guardian Details
** Please note that a benefit check cannot be carried out without these details
Your Details
Your Partners Details
Contact Details
Postal Address
Current Circumstances (Please tick applicable box(es) below) 
Which Benefits do you receive? (Please tick applicable box(es) below)
Details about all the children who you receive Child Benefit for that attend a school in Worcestershire
Child 1
Surname
Forename
Date of Birth
Present School
Child 2
Surname
Forename
Date of Birth
Present School
Child 3
Surname
Forename
Date of Birth
Present School
Child 4
Surname
Forename
Date of Birth
Present School
Child 5
Surname
Forename
Date of Birth
Present School
I certify that the information given is correct, and I will notify you immediately of any changes in my personal or benefit details.  I understand that you will use the information l have provided to process my claim for Free School Meals, and will contact other sources as allowed by the law to verify my initial, and ongoing, entitlement.
I understand the detail provided and results of the Free School Meal eligibility check are confidential so will be held securely and the check can be used by other Worcestershire County Council, Babcock Prime departments and schools to assess my entitlement to receive other services.