CHILDCARE APPLICATION FOR CHILDREN OF ESSENTIAL SERVICE WORKERS

Request In-Person Care & Learning Opportunities For Your Child(ren)

School District No. 52 (SD52) is taking steps and developing processes to support our families of essential service workers who must work during the COVID-19 pandemic to provide them access to childcare.

If you have a childcare need and are an essential service worker, please take a moment to fill out this application.

SD52 is following the direction of the Ministry of Education to develop a plan for providing in-person care and learning opportunities for children of essential service workers. SD52 is using the definition of an essential service worker provided by Emergency Management B.C.:

“Essential Service Workers (ESWs) are those individuals considered critical to preserving life, health and societal functioning - including emergency responders, front-line health care workers, and critical infrastructure and supply chain (e.g. food, medicine) workers.”

In-person care and learning opportunities for children of essential service workers is being planned for students in Grades K-5. However, we will consider providing this programming for children of essential service workers in other grades as well, depending on individual circumstances.

Health and safety protocols will be followed during in-person care and learning instruction.

If you are an essential service worker, and you would like to request to have your child(ren) considered for in-person care and learning opportunities, please complete this form.

It is important that parents/guardians exhaust all other possibilities for supervision of their child(ren) prior to accessing the in-person care and learning opportunities programming offered by SD52. This will help in our efforts to safely apply health and safety protocols as defined by the Provincial Medical Health Officer.

Please be aware that depending on the need and our available resources, we may be required to prioritize the career listing included in the definition of an essential service worker.

Please submit your application by the end of day Monday, April 6, 2020.

SD52 will be contacting you with further details by Thursday, April 9, 2020.

If you have any questions, please don’t hesitate to contact Ann Rowse at ann.rowse@sd52.bc.ca or 250.627.2157.

Question Title

* 1. Parent/Guardian Last Name & First Name (ie. Smith, Karen)

Parent/Guardian 1: Last Name, First Name

Parent/Guardian 2: Last Name, First Name

Parent/Guardian 3: Last Name, First Name

Parent/Guardian 4: Last Name, First Name

Question Title

* 2. Parent/Guardian Phone Number (ie. 2501234567)

Parent/Guardian 1: Phone Number

Parent/Guardian 2: Phone Number

Parent/Guardian 3: Phone Number

Parent/Guardian 4: Phone Number

Question Title

* 3. Parent/Guardian Email Address (ie. karen.smith@gmail.com)

Parent/Guardian 1: Email Address

Parent/Guardian 2: Email Address

Parent/Guardian 3: Email Address

Parent/Guardian 4: Email Address

Question Title

* 4. Parent/Guardian Occupation(s):

Health Care Service (acute care, long term care, public health)

Other Health Services (physician, nurse, pharmacists, etc)

Law Enforcement, Public Safety, First Responder, Emergency Response

Vulnerable Population Service Provider

Critical Infrastructure Service Provider

Food / Agriculture Service Provider

Licensed Daycare Provider

Other (please specify)

Question Title

* 5. Please provide a brief summary of the nature of your work and how it qualifies as an essential worker status.

Question Title

* 6. Are any of the parents/guardians able to work from home?

Yes

Part-time

Unsure

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* 7. What day(s) of the week and times of the day do you predict you will require childcare for your child(ren)? (Please fill in the time period under each day. Ie. 9:00am - 3:00pm. If no childcare required on a specific day of the week, please leave field blank.)

Monday

Tuesday

Wednesday

Thursday

Friday

Additional Details?

Question Title

* 8. Student(s) Last Name & First Name (ie. Smith, John)

Student 1: Last Name, First Name

Student 2: Last Name, First Name

Student 3: Last Name, First Name

Student 4: Last Name, First Name

Student 5: Last Name, First Name

Student 6: Last Name, First Name

Student 7: Last Name, First Name

Student 8: Last Name, First Name

Question Title

* 9. Student(s) date of birth (ie. YYYY/MM/DD)

Student 1: Date of birth

Student 2: Date of birth

Student 3: Date of birth

Student 4: Date of birth

Student 5: Date of birth

Student 6: Date of birth

Student 7: Date of birth

Student 8: Date of birth

Question Title

* 10. Student(s) current grade

	Grade
Student 1	Student 1 Grade menu
Student 2	Student 2 Grade menu
Student 3	Student 3 Grade menu
Student 4	Student 4 Grade menu
Student 5	Student 5 Grade menu
Student 6	Student 6 Grade menu
Student 7	Student 7 Grade menu
Student 8	Student 8 Grade menu

Please specify any further details.

Question Title

* 11. Student(s) current school

	School
Student 1	Student 1 School menu
Student 2	Student 2 School menu
Student 3	Student 3 School menu
Student 4	Student 4 School menu
Student 5	Student 5 School menu
Student 6	Student 6 School menu
Student 7	Student 7 School menu
Student 8	Student 8 School menu

Please specify any further details.