(Office use only)
SfYC Professional Options
Service Request Form
Organisation name: / Purchase date:Head/Owner/Manager: / Term training/support is required:
Summer 2017 (April-July):
Autumn 2017 (Sept- Dec)
Spring 2018 (Jan – March):
Customer contact name
Customer contact role:
Contact email: / Contact number
Address:
DfE number (for school, academy, college/university use only):
Maintained Academy College/university
URN Ofsted Number (for PVI provider, Children’s centreonly):
PVI provider Children’s centre
Payment details: (please complete one box only)
IBC Trading details:(Insert PO number you raise) / BACS receipt attached
Yes / No / Cheque enclosed
Yes / No
If you have had a discussion with a member of the SfYC team about your requirements, please provide their name/contact details here:
Title of Support/Training you are purchasing:
To purchase Support and/or Training please mark X in the relevant boxes below
SUPPORT / Please indicate how many additional hours needed
½ day £300 (3 hours support) / Full day £600 (6 hours support) / Report £100 per report / Additional hours £100 per hour
TRAINING
½ day £300 (3 hours training)
20 people max attending / Full day £600 (6 hours training)
20 people max attending / Additional hours £100 per hour
Terms and Conditions
SfYC and schools/organisations will inform each other as soon as possible if illness of a staff member could disrupt planned arrangements. In the event of unavoidable absence, in either SfYC or a school, every effort will be made to provide mutually agreed alternative arrangements in order to supply the service. SfYC reserves the right to charge schools/organisations for the time booked if a cancellation is made by a school/organisation without mutual agreement.
Any additional cost occurred due to the cancellation with be agreed on a case by case basis.
The information on this form will be used as the basis for charging for the visit at the appropriate SfYC rate unless amendments have been agreed. Additional work undertaken at the time of the visit or subsequently (e.g. production of a report not originally requested) will be charged accordingly.
If you agree with the service and associated cost as detailed above, please sign and date below. If you wish to make any amendments please email me within 4 days of receiving this agreement.
Signature…………………………………………………………………… date……………………………………….
Office use only
Date form/payment received:
Purchase made in: Q1 :Apr – June Q2 :July – Sept Q3 :Oct – Dec Q4 :Jan - Mar
Date payment confirmation sent to relevant team:
Date training/support confirmation sheet received:
Please email completed form to:
Please send cheques to:
Services for Young Children - Professional Options
Children's Services Department
Elizabeth II Court North
The Castle
Winchester
SO23 8UG
For general enquiries or support filling out this form please contact:
SfYC PO Support Team
01962 847073
Professional Options Payment form – April 2017