Childcare Subsidy Application Form 2016/2017

Childcare Subsidy Application Form 2016/2017

INSTITUTE OF TECHNOLOGY TALLAGHT

CHILDCARE SUBSIDY APPLICATION FORM 2016/2017

Information for full time undergraduate & post graduate students regarding financial subsidy for onsite crèche.

Purpose and financial support

  • The purpose of the Childcare Subsidy is to provide a subsidy to registered full time students towards the cost of child care in the institute onsite crèche.
  • The Institute will provide limited financial support for registered full time students who are in regular attendance and good financial standing with the Institute.
  • Funding is limited and applications can only be considered when funding is available.
  • The subsidy is not available to apprentices and part-time students, incoming students on Erasmus programmes or equivalent, postgraduate (paid) research students.
  • Applications will consider household income (see page 2)

Financial Support

  • The subsidy is €100 per week up to a maximum of 15 weeks for each semester.
  • The subsidy will be paid directly to the Crèche provider on the student’s behalf.
  • The subsidy is ex-gratia and may be revoked at any time.
  • The subsidy is subject to satisfactory attendance at classes and the student being in good financial standing with the Institute.
  • Each application will be reviewed during the year.

Process

  • Registered students should contact the Crèche and complete the appropriate forms. i.e. Fledglings applicationform for a place.
  • IT-Tallaght Students Union Welfare Officer can provide the application form for the Childcare Subsidy (CS)
  • The completed application form for CS support should be submitted to Students’ UnionDeputy Welfare Officer with original birth certificate for each child and evidence of receipt of child welfare benefits from Department of Social and Family Affairs.
  • The Institute’s Childcare Subsidy Committee will assess each application and a decision will be reached regarding whether or not the student will receive the Childcare Subsidy from the Institute.
  • Both the student and the Crèche provider will be informed as to whether or not financial support will be provided and if so the amount approved.
  • In making its decision the Childcare Subsidy Committee reserves the rights to verify data submitted by the applicant.
  • The Childcare Subsidy is administered by the CAF Committee
  • Members of the CAF Committee:
  • Academic Administration and Students Affairs Manager
  • Students’ Union Welfare Officer or ph: 4042562

Application Form for Financial support from Childcare Subsidy

(Note- a separate application form should be completed for Fledglings)

  1. Personal Details:

Name: / Home Phone:
Address: / Mobile:
Email:
  1. Children’s Details

(Evidence of electronic funds transfer for children’s allowance and original birth certificate required)

Name: / Age: / Date of Birth:
  1. Household Income:

Are you in receipt of Yes/NoAmount per week?

Maintenance Subsidy
Top-up Subsidy
Back to education allowance
Disability allowance/benefit
One parent family payment
Rent allowance
Medical Card
Financial support from Home/Parents
Yes/No / Amount per week
Have you any other source of Income
If source of Income is part-time job, please state number of hours per week
Do you receive financial support from other schemes in the institute (e.g. scholarship)?
Student Assistance fund
Disability Fund
Emergency student welfare Fund
Were you in receipt of Childcare Subsidy from the institute last semester?
  1. Expenditure

Please list your weekly/monthly expenditure e.g. Rent/Mortgage/Utilities (excluding childcare)

Expenditure: / Amount per week: / Amount per month:

I certify that I am a registered full time student in the Institute of Technology Tallaght for the Academic year ______(2016/17 insert as appropriate) and that the information supplied on the application form is true and accurate. I hereby apply for financial support from the CS Committee for this academic year only.

In accordance with the Data Protection Acts 1988 and 2003, the Institute requires your consent to take and use your personal data and your child’s personal data for the purposes of this application. This data will be used by the institute for the purpose of processing this application and the Institute providing the relevant financial support (if this application is successful).

In compliance with the Data Protection acts 1988 and 2003, the Institute will: (a) store this data securely; and (b) not unlawfully disclose this data to any other person.

This consent will continue until your child stops using the crèche facilities at the end of this academic year ______(insert current academic yr. e.g. 2016/17) (if your application is successful) and the data is no longer required by the institute.

Please sign and date this form if you agree to the above.

Signed…………………………………………………

Name…………………………………………………

Date………………………………………………..

FOR OFFICE USE ONLY

Application Date of Application:

Documents Date Approved:

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