Chasetown Community School

Key Workers questionnaire

Name of child in school

Name of Parent/Carer 1

Contact number of Parent/Carer 1

Email of Parent/Carer 1

Occupation of Parent/Carer 1

Name of Company

If delivery driver, what type of items do they deliver?

Please complete if second parent / carer is also a Key Worker

Name of Parent/Carer 2

Contact number of parent 2

Email address of parent / carer 2

Occupation of parent / carer 2 (if applicable)

Name of company of parent 2

If parent 2 is a delivery driver, what type of items do they deliver?

Days required to work (Monday, Tuesday, Wednesday, Thursday, Friday) Please type all that apply below

Is there anything else we need to know? This may also include information such as whether you are unlikely to take up the place even if you are eligible or if you are currently self-isolating and estimated end date.

Do you have a childcare bubble? Please see below link for more information.

Information on child care bubbles

https://www.gov.uk/guidance/national-lockdown-stay-at-home?priority-taxon=774cee22-d896-44c1-a611-e3109cce8eae#childcare

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Chasetown Community School

Key Workers questionnaire

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