Education, Health and Care Plan Early Years Setting/School/ Post 16 Providers Contribution Family name: Given names: DoB Gender: Address: Parent/ Carers name: Contact Number: Ethnicity: Year Group: Is the Child /Young If yes, name of Person a Looked After Social Worker Child/Young Person Years Setting/ School/ Post 16 Provider Details Name of setting: Date of pupil’s admission Attendance Actual % Possible % Does the school receive Pupil Premium IF YES Please confirm the amount funding for this child/young person? received Pupil Premium YES/NO (delete as applicable) £ People and Services working with child/ young person and family Address / Contact Details (phone Agency Name Role
Education, Health and Care Plan Early Years Setting/School/ Post 16 Providers Contribution Family name: Given names: DoB Gender: Address: Parent/ Carers name: Contact Number: Ethnicity: Year Group: Is the Child /Young Person a Looked After Child/Young Person If yes, name of Social Worker Years Setting/ School/ Post 16 Provider Details Name of setting: Date of pupil’s admission Attendance Actual % Possible % Pupil Premium Does the school receive Pupil Premium funding for this child/young person? YES/NO (delete as applicable) IF YES Please confirm the amount received £ People and Services working with child/ young person and family Agency Name Role Address / Contact Details (phone