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Childcare Request Form
EF1025
Once you have completed the form below, click on 'Submit' to send. Your enquiry will be sent to INFORM 0-19. We will aim to reply on our next working day. If you make a mistake or would like to start again click on 'Cancel'. You will have the opportunity to print details of your request for your records after you have submitted it.
Name:
*
Address:
*
Post Code:
*
Email:
Telephone / Mobile No:
*
Fax Number:
Please select how you would like the information to be sent to you:
*
Post
Email
Fax
Please indicate what type of childcare you require. You may select more than one type:
*
Childminders
Children's Activities
Holiday Scheme
Nanny Agencies
Out of School Clubs
Parent & Toddler Groups
Pre-School / Playgroup
Private Day Nurseries
Other (please state)
Other Childcare Type:
*
Age(s) of Child(ren):
*
Location of Childcare. You may select more than 1 location:
*
Ampthill
Arlesey
Aspley Guise
Aspley Heath
Barton-Le-Clay
Bedford
Beeston
Biddenham
Biggleswade
Bletsoe
Blunham
Brickhill
Brogborough
Bromham
Broom
Caddington
Campton
Cardington
Carlton
Chalton
Chicksands
Clapham
Clifton
Clophill
Colmworth
Cople
Cotton End
Cranfield
Dunstable
Dunton
Eaton Bray
Elstow
Eversholt
Everton
Eyeworth
Felmersham
Flitton
Flitwick
Goldington
Gravenhurst
Great Barford
Great Billington
Greenfield
Harlington
Harrold
Haynes
Heath And Reach
Henlow
Henlow Camp
Hockliffe
Houghton Conquest
Houghton Regis
Husborne Crawley
Ickwell
Kempston
Kempston Hardwick
Kempston Rural
Kensworth
Keysoe
Langford
Leighton Buzzard
Lidlington
Linslade
Lower Stondon
Marston Moretaine
Maulden
Melchbourne
Meppershall
Millbrook
Milton Bryan
Milton Ernest
Moggerhanger
Northill
Oakley
Odell
Old Warden
Podington
Potton
Pulloxhill
Putnoe
Queens Park
Radwell
Ravensden
Renhold
Ridgmont
Riseley
Roxton
Sandy
Sharnbrook
Shefford
Shelton
Shillington
Shortstown
Silsoe
Slip End
Southill
Stanbridge
Stanford
Steppingley
Stevington
Stewartby
Stondon
Stotfold
Streatley
Studham
Sundon
Sutton
Tempsford
Thurleigh
Tilsworth
Toddington
Turvey
Upper Caldecote
Upper Dean
Upper Stondon
Upper Sundon
Westoning
Wharley End, Cranfield
Wilden
Willington
Wilstead
Woburn
Woburn Sands
Wootton
Wrestlingworth
Wyboston
Wymington
If you require a school pick up / drop off, please specify the name of the school / pre-school:
Please tick hours required:
All Day
AM
PM
Before 7.30am
After 6pm
School Holidays
Saturday
Sunday
Overnight
Any additional information required / comments:
Data Protection Act 1998
Please note that the personal details supplied on this form will be held on a file and/or computerised by Bedford Borough Council for the purposes of processing your childcare request. Your personal details may be shared internally within the Council for this purpose, but will be safeguarded and will not be divulged to any other individuals or organisations for any other purposes.
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