Irlam Primary School

Key Worker Questionnaire

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. PLEASE INCLUDE AS MUCH AS INFORMATION AS POSSIBLE.

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.

ONLY SUMBIT ONE FORM - ONCE YOU CLICK SUBMIT A SMALL MESSAGE WILL APPEAR AT THE TOP OF THE PAGE TELLING YOU IT HAS BEEN SUBMITTED. YOU DO NOT NEED TO COMPLETE ANOTHER FORM.

PLEASE NOTE THAT NO DECISION TO CLOSE SCHOOLS HAS YET BEEN MADE. CURRENTLY WE ARE EXPECTING THE CHILDREN BACK IN SCHOOL AT WEDNESDAY 6TH JANUARY.

Key Worker Information

It is important that you only complete this form if both parents or in the case of a single parent household one parent is an essential key worker. Completion of this form does not guarantee a place in the event of a closure. It is important you include as much information as possible to help us make the correct decision.

Name/Year group of child 1

Name/Year group of child 2 - please put n/a if not applicable.

Name/Year group of child 3 - please put n/a if not applicable.

Name/Year group of child 4 - please put n/a if not applicable.

Are both parents (or in the case of a single parent household, one parent) considered an essential key worker?

Parent 1 - Name

Parent 1 - Email and mobile number

Parent 1 Please describe your essential key worker role - include as much information as possible including job role, key worker category, employer and hours of work.

Parent 2 - Name

Parent 2 - Email and mobile number

Parent 2 Please describe your essential key worker role - include as much information as possible including job role, key worker category, employer and hours of work.

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Key Worker Questionnaire

Key Worker Information

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