Application for Childcare Vouchers

Royal Holloway University of London

Name …………………………………………………………………….………...…..

Department ……………………………………………………………………….…….

Payroll Number ………………………………………………………………………...

I would like £ …………….... of childcare vouchers a month, for the next 12 months.

Please note that the maximum available a month is £243. Amounts less than the maximum should be in multiples of £10.

The child/children for whom I am responsible and will pay for childcare is/are:

Name Date of Birth

1 .…………………………………….…… ……………….

2 ………………………………………….. ……………….

3 ………………………………………….. ……………….

4 ………………………………………….. ……………….

5 ………………………………………….. ……………….

The Registered Child Carers I intend to use is/are:

Name and Address of Organisations

1.……………………………………………………………………………………. ………………………………………………………………………………………………………………… …………………………………………………………….………

2………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………… …………………………………………..

3……………………………………………………………………………………… ………………………………………………………………………………………… …………………………………………………………………………………………

The information provided on this application form will be held in accordance with the Data Protection Act 1988. The College is required to hold this data in order to comply with Inland Revenue regulations. Please read the following carefully before signing this application form.

This is a salary sacrifice scheme. You should be aware that joining this scheme constitutes a contractual change to your terms and conditions of employment. You will cease to be entitled to your original salary whilst you are a member of the scheme and will instead receive an adjusted salary and childcare vouchers to the value you have stated above.

Childcare Vouchers will be issued on behalf of Royal Holloway, University of London by Edenred. Edenred will manage your Childcare Voucher account and issue you with a unique account number and details of how to spend your vouchers.

In order to be eligible for childcare vouchers you must meet the following conditions:

1 You must be the parent or other legal guardian of the child or children for whom you require the vouchers.

2 Following the adjustment of your monthly income by the value of the childcare vouchers, your average hourly rate must not fall below the current minimum wage. If your hourly rate does fall below the current minimum wage an hour you will not receive any childcare vouchers in that month. If you are an hourly paid member of staff and/or your hours vary from month to month you may wish to discuss your case with Human Resources before submitting this application.

You should also be aware of the following rules of the scheme:

3 You may not leave the scheme, or change the value of childcare vouchers you receive, within 12 months of joining unless you are subject to a significant change in circumstances following a lifestyle change e.g. a change in working hours, pregnancy, redundancy of a partner or divorce. If you leave the scheme you will not be able to rejoin within the same financial year regardless of any change in circumstances. You must notify the Human Resources Department in writing if you wish to leave the scheme, or change the value of the vouchers you receive, because of a lifestyle change.

4 You will have the option to leave the scheme or change the value of vouchers you receive at the end of 12 months.

5 You are responsible for selecting the institution or individual providing the childcare. You may only use the vouchers to pay for registered childcare and must notify the College if your selected childcare provider loses its registered status or if you change childcare providers.

6 If you are a member of one of the College’s pension schemes your pension deductions will be calculated on your original salary and not on the value of your adjusted salary.

I have read and understood the conditions and rules of the Childcare Voucher scheme as detailed above and would like to apply to join the scheme. I confirm that all the information I have given is correct and that I agree to comply fully with the rules of the scheme.

Signed ……………………………………………… Date ………………………

The information provided on this application form will be held in accordance with the Data Protection Act 1988. The College is required to hold this data in order to comply with Inland Revenue regulations. Please return this application form to your relevant HR Assistant in Human Resources as follows:

If you have any queries or wish to apply for childcare vouchers please contact the relevant email address as given below:

Faculty of Science at [email protected] Faculty of Arts and Social Science at [email protected] Faculty of Management and Economics at [email protected] Professional Services at [email protected]

Once this application form has been received and processed you will be sent a change of contract letter which you must sign and return before you can start to receive Childcare Vouchers.

The information provided on this application form will be held in accordance with the Data Protection Act 1988. The College is required to hold this data in order to comply with Inland Revenue regulations.