For more information about the Wiltshire Short Breaks Scheme go to Wiltshire Parent Carer Council.
If you need help to complete this form, please call the Wiltshire Parent Carer Council on 01225 764647.
You are advised to print or keep a copy of the application submission page as a record of your application.
- 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.