Repeat Early Years Funding request
This form is to be completed for a repeat application for a child for whom funding has already been agreed
Name of the child………………………………………………………Date of Birth………………………………..
Name of the Early Years setting……………………………………...... Number of hours child attends each week ......
Does this include the 30 hours extended entitlement? YES / NO
Name of SENCO at setting ......
Contact details for setting ......
Telephone number ...... Email address ......
Previous funding?
How much funding is requested?
What period will this funding cover?
Please provide an update on the child's progress and needs including an Early Years Plan (IEP). Please also include any updated information from other professionals who are supporting the child.
Previous identified targets /outcomesDate: / Progress made / Current identified targets /outcomes
Date:
1.
2.
3.
4.
5.
PROVISION MAP (EXAMPLE)
Name ………………………………………………. D.O.B…………………………………... Date of intervention …………… Review Date ......
Key person…………………………………………. SENCO………………………………… Date of request for funding ………......
Provision to meet outcomes / MondayAm Pm / Tuesday
Am Pm / Wednesday
Am Pm / Thursday
Am Pm / Friday
Am Pm / TOTAL
Listen with Lucy / 10 mins
9.30 -9.40 / 10 mins / 10 mins / 10 mins / 40 mins
SALT Intervention / 10 mins / 10 mins / 10 mins / 10 mins / 50 mins
Story time pre learning / 10 mins / 10 mins / 10 mins / 30 mins
forest school support / 40 mins / 40 mins
Planned Back chaining / Circle time
10 mins / Circle time
10 mins / Circle time
10 mins / Circle time
10 mins / Circle time
10 mins / 50 Mins
Incidental opportunities to support
Total time / 3.5 hrs
One off costs / purchases specific to child / Cost
Story sack / £39.99
Printing photos/laminating (for visual aids) / £20.00
Remember to look at when you are planning pre-story learning (possibly the week before).
Back chaining – ask for support to do this and plan ahead. Time joining in should increase over the term, but time to support should be the same.
Add time or minutes up to you.
Provision map below to be completed to show when and how the child will be supported in the setting.
PROVISION MAPName ……………………………………………….. D.O.B…………………………………... Date of intervention …………… Review Date ......
Key person…………………………………………. SENCO………………………………… Date of request for funding ………......
Provision to meet outcomes / MondayAm Pm / Tuesday
Am Pm / Wednesday
Am Pm / Thursday
Am Pm / Friday
Am Pm / TOTAL
One off costs / purchases specific to child / Cost
Any additional information to support this request:
Setting manager: (signature)Setting SENCO: (signature)
Contact name: Telephone number: Secure email:
Speech chart / Learning plans / Professional advice / Portage / SALT / Physio / Health Visitor / Other