Telephone No Comments Is the Pupil a LAC Yes No Have been any CAF / EHA meetings called Yes No Is the Pupil on a Child Protection Plan Yes No Contact: Please specify Lead Contact person and tel no. Telephone: Does the pupil have an IEP / PSP. If yes please Yes No Contact: attach last available copy of IEP/PSP Telephone: **School to include PSP/IEP Plan Has the Pupil been the subject to a Managed Yes No Move. Name of School: If yes please provide the following Last Review Date: Information:- Date of Breakdown: Reason for Breakdown: Does the Pupil have an SEN Please specify SEN Yes No Does the Pupil have an EHCP – type Plan? Yes/No Please attach a copy of the most SPLD/MLD/SLD/PMLD/ASD/HI/VI/MSI/PD/ (Please specify) recent if yes Does the pupil currently receive in class Yes No Details: support? Frequency/subject/hours: If the Child has an EHCP Plan please provide Key Worker Name – Keyworker Name and Contact Number Contact Number Is the pupil in receipt of Free School Meals Yes No Does the pupil attract Pupil Premium Yes No Ethnicity (Please tick one box) WBRI AIND British Indian Irish WIRI Pakistani APKN Traveller - Heritage WIRT Bangladeshi ABAN Any Other Asian BOTH Gypsy/Roma Background Any Other White WOTH CHNE Chinese Background MWBC OOTH White/Black Caribbean Any Ethnic Group MWBA REFU White/Black African Refused MWAS White/Asian Any Other Mixed MOTH Traveller TRV Background Black Caribbean BCRB Asylum Seeker ASY Black African BAFR Any Other Black BOTH Background Exclusion Reason (Please tick one box) PP SM Sexual misconduct Physical assault against a pupil PP PA Physical assault against an adult DA Drug and alcohol related VP Verbal abuse/threatening behaviour against DM Damage VA a Verbal pupil abuse/threatening behaviour against TH Theft BU Bullying an adult DB Persistent Disruptive Behaviour RA Racist Abuse OT Other
Telephone No Comments Is the Pupil a LAC Yes No Have been any CAF / EHA meetings called Yes No Is the Pupil on a Child Protection Plan Please specify Lead Contact person and tel no. Yes No Contact: Telephone: Does the pupil have an IEP / PSP. If yes please attach last available copy of IEP/PSP Yes **School to include PSP/IEP Plan No Contact: Telephone: Has the Pupil been the subject to a Managed Move. If yes please provide the following Information:- Yes No Name of School: Last Review Date: Date of Breakdown: Reason for Breakdown: Does the Pupil have an SEN – Please specify SEN type Yes No Does the Pupil have an EHCP Plan? Yes/No Please attach a copy of the most recent if yes SPLD/MLD/SLD/PMLD/ASD/HI/VI/MSI/PD/ (Please specify) Does the pupil currently receive in class support? Yes No Details: Frequency/subject/hours: If the Child has an EHCP Plan – please provide Keyworker Name and Contact Number Key Worker Name Contact Number Is the pupil in receipt of Free School Meals Yes No Does the pupil attract Pupil Premium Yes No Ethnicity (Please tick one box) British WBRI Indian AIND Irish WIRI Pakistani APKN Traveller - Heritage WIRT Bangladeshi ABAN Gypsy/Roma Any Other Asian Background BOTH Any Other White Background WOTH Chinese CHNE White/Black Caribbean MWBC Any Ethnic Group OOTH White/Black African MWBA Refused REFU White/Asian MWAS Any Other Mixed Background MOTH Traveller TRV Black Caribbean BCRB Asylum Seeker ASY Black African BAFR Any Other Black Background BOTH Exclusion Reason (Please tick one box) PP PP Physical assault against a pupil SM Sexual misconduct PA Physical assault against an adult DA Drug and alcohol related VP Verbal abuse/threatening behaviour against a pupil DM Damage VA Verbal abuse/threatening behaviour against an adult TH Theft BU Bullying DB Persistent Disruptive Behaviour RA Racist Abuse OT Other
notification-of-permanent-exclusion-2018_2_.docx