Welsh Government Funded Childcare for 2 Year Old Application Form

Details of the Child

Full name of the child *

Address of the child *

Date of birth of the child *

Gender of the child *

Male

Female

I prefer not to say

The ethnicity of the child *

Main home language of the child *

If other, please specify *

I think my child may have a health, behaviour or development issue which may require extra care or help *

Yes

I prefer not to say

Please add more details *

Parent / Carer 1 Details

Full Name of Parent/Guardian *

Parent/Carer Contact Number *

Parent/Carer Date of Birth *

Relationship of the Parent/Carer to the Child *

Email address *

Preferred Speaking Language of the Parent/Guardian *

If other, please specify *

Preferred Written Language of the Parent/Guardian *

If other, please specify *

Parent / Carer 2 Details

Full Name of Parent/Guardian

Parent/Carer Contact Number

Parent/Carer Date of Birth

Relationship of the Parent/Carer to the Child

Email address

Preferred Speaking Language of the Parent/Guardian

If other, please specify

Preferred Written Language of the Parent/Guardian

If other, please specify

Evidence

(We will accept scanned copies, or clear photographs taken by phone) All additional documents will be destroyed/deleted once your application has been assessed. The Gwynedd Childcare Unit may ask you to supply original documents to support your claim at any time during this Childcare Offer. (Please note that without these documents we will not be able to process your application) Documents required: Child’s Birth Certificate Council Tax Bill from 2026-2027 or a utility bill dated within the last three months.

Attach*

Botwm Atodi

Label Disgrifiad

Confirmation details

If you need more information or help with the application form, please contact 01248 352 436 / 01286 678 824 or gofalplant2oed@gwynedd.llyw.cymru. The above information will be used in order to provide the 2 year old childcare service to you. If necessary, it will be shared with the Nurseries, Cylchoedd Meithrin, Childminders and Schools. Some information may also be shared with Swansea University for the Welsh Government to monitor the scheme. Contact us if you want to know what the service retention period is. For more details on how we use your information go to the Privacy section on the Cyngor Gwynedd website. I understand that: By signing this application form, I declare that all the information I have given is correct. If any information I have given is found to be incorrect and I do not meet the criteria for the scheme, I understand that my child will lose his place on the scheme immediately and that further steps can be taken to recover the cost of the childcare. That the Gwynedd Child Care Unit will check my documentation to see if I am eligible and that I can be asked to produce further evidence of my qualification. If I am found to be ineligible, the government funded childcare will be formally withdrawn. That the information provided by me will be used by the Gwynedd Childcare Unit to compare my application with the eligibility criteria. It is also used for statistical analysis purposes. Information is shared with the Family Information Service and processed in accordance with the Data Protection Act 1998 and any amendments to that Act.

I agree that I have completed the form with the correct details and agree to the conditions above. *

Llofnod *

How did you find out about the Welsh Government Funded Childcare for 2 Year Old?

Select all options that apply and provide more details if necessary.

Radio

Banners in your area

Gwynedd Council Website

Teulu Gwynedd Social Media

Information from a member of the Council or Health Team

Childcare Provider

Other

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