Irlam Primary School
- Survey
Key Worker Information
In light of the current situation and the need to plan for possible closure we are asking the following: IF YOU ARE IN A HOUSEHOLD WHERE BOTH PARENTS ARE ESSENTIAL KEY WORKERS WHO ARE UNABLE TO WORK FROM HOME OR A SINGLE PARENT HOUSEHOLD WITH A KEY WORKER WHO IS UNABLE TO WORK FROM HOME - PLEASE COMPLETE THE FOLLOWING FORM INCLUDING AS MUCH DETAIL AS POSSIBLE TO HELP US TO MAKE A DECISION. IF SCHOOL CLOSES AND YOU CAN KEEP YOUR CHILDREN AT HOME - YOU MUST DO SO. THIS IS TO KEEP EVERYONE, INCLUDING STAFF AND THEIR FAMILIES SAFE. WE WILL CONSIDER EACH RESPONSE FORM ON AN INDIVIDUAL BASIS. COMPLETION OF THIS FORM DOES NOT GUARANTEE A PLACE IN THE EVENT OF A CLOSURE - YOU WILL BE INFORMED OF A DECISION AS SOON AS POSSIBLE.
Q1. Please enter the details of all children who attend our school. If you have fewer than 4 children, please write n/a in any empty fields. For each child please provide both their name and class.
Child 1
Child 2
Child 3
Child 4
Q2. Parent 1: Full Name
Q3. Parent 1: Contact Details
Telephone Number
Email Address
Q4. Parent 1: Are you employed?
Yes
No
Q5. Parent 1: Are you self-employed?
Yes
No
Q6. Parent 1: Occupation & Employer (enter n/a if not relevant)
Occupation - please include as much detail as possible
Employer
Q7. Parent 2: Full Name (Optional)
Q8. Parent 2: Contact Details (Optional)
Telephone Number
Email Address
Q9. Parent 2: Are you employed? (Optional)
Yes
No
Q10. Parent 2: Are you self-employed? (Optional)
Yes
No
Q11. Parent 2: Occupation & Employer (enter n/a if not relevant) (Optional)
Occupation - please include as much detail as possible
Employer
Submit