ECCE REF NO:________________
(EXISTING PROVIDER)
SETTLING IN TRANSFER FORM
Early Childhood Care & Education (ECCE) Programme
Part A – To be completed by existing Pre-school Service (BLOCK CAPITALS)
I, ____________________________________________________ Manager/Owner (circle as approp.)
at _____________________________________________ Pre-school, ECCE Ref No: _____________
where ____________________________has been attending the ECCE Programme, for ___ days a week.
This child last attended on / I have been informed that s/he will not be attending this service from
Date:_____/_____/_____ and understand that no further capitation will be paid by DCYA to this
service in respect of this child from Date:_____/______/____
(ECCE payment date - not later than 28/09/2012).
Signed ________________________________________________
Date:____/____/____
Part B – To be completed by Parent/Guardian (BLOCK CAPITALS)
I,____________________________________Parent/Guardian of _____________________________
Child’s PPS No. is ________________, apply for his/her ECCE capitation to be transferred
to ________________________________________ Pre-school, effective from Date::_____/______/____.
I declare that this child has not been supported with Community Childcare Subvention (CCS)
programme or any Dept of Education & Skills scheme this academic year.
Signed ________________________________________________
Date:____/____/_____
Part C – To be completed by the New Pre-school Service (BLOCK CAPITALS)
I, _______________________________________,
Manager/Owner (circle as approp.) at _____________
_________________________ Pre-school ECCE Ref. No:___________, have allocated a ____ day week
ECCE Programme to the above child from Date:___/____/____.
(Date not earlier than ECCE payment date specified in Part A above)
Signed __________________________________________________
ECCE Form 11 – Settling In Transfer Form
Date: ___/____/_____
06/02/2016