Who are you completing this application for?
Does your child have an education, health and care plan?
Are you able to work from home during your isolation period?
Will you have a reduction in earned income?
Are you currently in receipt of furlough pay?:
Have you travelled abroad within the last 3 months?
Are you in receipt of the Covid-19 Self-Employment Income Support Scheme grant from HMRC?:
Which of the following benefits/support do you receive?
I agree to the above declaration: