Unsure. 12. How knowledgeable do you believe you are about Sickle Cell Disease (SCD)? Very knowledgeable about SCD Knowledgeable about SCD Somewhat knowledgeable about SCD Not knowledgeable about SCD
Unsure. 308 Do you approve of family planning methods use by your partner? 1. Yes 2. No 3. Other(specify) 309 Which family planning methods do you think is safe to use by your partner(see code below and write all choices) 310 For what purpose do you think that child spacing or having fewer children is important? 1. For the mother health 2. For economical purpose 3. For the health of child 4. Other(specify) Code for Q304,Q309,Q402,Q404,Q407
Unsure. Is the sharing of the information essential to the wellbeing/educational welfare of the pupil? Have you been given explicit consent to disclose the information? Seek advice.
Unsure. 7. Describe the proposed use of the Material by the Requestor (you may attach a copy of the request). Be specific:
Unsure. References - List one school, work or personal reference we may contact. Do not list family members. Name Relationship to You How long have you known this person? Type of Reference (School, Work or Personal) Phone Custodial Parent/Guardian: I certify that I am a custodial parent/guardian and give the aforementioned permission to volunteer with A Beautiful Me. Signature of Parent/Guardian: PRINT Parent/Guardian Name: A Beautiful Me | 000 Xxxxx Xxxxxx, Xxxx Xxxxx, XX 00000 | 000-000-0000 | XXxxxxxxxxXx.xxx The CLOSET by A Beautiful Me | 000 Xxxxx Xxxxxx, Xxxx Xxxxx, XX 00000 | 000-000-0000 | XXxxxxxxxxXxXXXXXX.xxx 20190805
Unsure. If you’re not sure whether you receive one of the listed benefits, or what your household income is, but you would still like us to check whether your child is eligible for free school meals, please place an X in this box DECLARATION The information I have given on this form is complete and accurate. I understand that my personal information is held securely and will be used only for local authority purposes. I agree to the local authority using the information I have provided to process my application for free school meals and will contact other sources as allowed by law to verify my initial and ongoing entitlement. I understand that the result of any free school meal eligibility check may also be used to assess my entitlement to receive free school milk and free travel to school. Name of parent/guardian: …………………………………………………………. Date:………………………. Thank you for completing this form and helping to make sure your child’s school is as well funded as possible. How the information in this form will be used The information you provide in this form will be used by the council to confirm receipt of one of the listed welfare benefits. Once this is confirmed, this helps to decide how much money your child’s school will receive each year. The information will also be used to decide whether your child is eligible for free school meals. You only need to complete this form once and it will last for the duration of your child’s time at their current school. We are committed to ensuring that the personal and sensitive information that we hold about you is protected and kept safe and secure, and we have measures in place to prevent the loss, misuse or alteration of your personal information. We will use the information you provide to assess entitlement to free school meals. The information may also be shared with other Council departments to offer benefits and services. Important Note Once you have been awarded free school meals, even if there are changes to your income that means you normally would no longer be entitled, your child will continue to receive free school meals until the end of the Universal Credit rollout period, which is currently scheduled to end in September 2024. Once Universal Credit is fully rolled out, your child will keep their free school meal until the end of their current phase of education, i.e. primary or secondary.
