Fields marked * are required.

Information about the child
















Your choice

The options are summarised below


Scheme payment

Payable directly to families to enable children or young people aged 6-18 to access short breaks for the support of their choice.
(If you would like Wiltshire Council to look after the money and manage it on your behalf, please contact the WPCC).

Up to £440 for approved applications received by Thursday 28 February 2019.


Barnardo’s Activity Clubs

Available on Saturdays and during school holidays.

84 hours of activity clubs for approved applications received by Thursday 28 February 2019.


The Combo

A combination of Barnardo’s activity clubs and scheme payment.

Up to £220 and 42 hours of activity clubs for approved applications received by Thursday 28 February 2019.


If you would like help from Barnardo’s to book sessions (please tick) :


Deadline for 2019-20 applications is Thursday 28 February 2019.






I would like some help choosing

If you need some help choosing please select this option from the drop down above and we will contact you.

Parent/carer information


















 
If you received a letter from us about Short Breaks this year, it will have included a reference number (like A12345B). Please quote it here to help speed up the application process.
Register with the Wiltshire Parent Carer Council

By registering, you will receive regular updates about leisure activities and short breaks plus other useful information. The WPCC stores contact information for parent carers on its computer database and Your Mailing List Provider for the purpose of sending information relevant to parents and carers of children and young people with SEND. The WPCC does not share parent carers’ details with third parties.

Submit form

Data Statement

By submitting this form you are consenting to your information being passed to agencies outside of Wiltshire Council for the purpose of arranging your choice of short break.

By applying for the Scheme's Payment or COMBO option, you are consenting to take part in an interview to understand how the funding was used responsibly to benefit your child and meet their leisure interests. Families asked to take part in an interview will be randomly selected.


It is the applicant’s responsibility to ensure that the application has been received.

Please note your application is not complete until you see the application submission page which should appear once you send this form.