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To complete a referral to our Alternative Provision service, please complete the details as needed. The Referrer should complete this with the parent present or with verbal permissions granted for consent.

Does the child help look after someone at home? (For example: providing regular practical help, emotional support, translation, supervision, or helping to keep a parent, sibling, or family member safe.)
Child's date of birth
Day
Month
Year
Safeguarding status:
Proposed start date
Day
Month
Year
Proposed end date
Day
Month
Year
Choose a Learning Package - please note we may facilitate some small group sessions, alongside one to one, if we believe that these can contribute meaningfully towards positive SEMH outcomes, and/or meeting learning objectives *
Do we need to attend a PEP or Annual Review meetings?
Yes
No
Unsure
What days/times are you available during school hours? (9am-4pm)
Is there parental/guardian consent for photos/videos of the child to be used for STC internal use only?
Is there parental/guardian consent for photos and videos of the child to be shared on STC social media?
Is there parental/guardian consent for photos/videos of the child to be used on STC website/advertising materials?
Is there parental/guardian consent for transport?
Is there parental/guardian consent for first aid?
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Pricing:

£55 + VAT for 1:1 tuition

£40 per hour small group tuition


Once we receive this information, we will get back to you with proposed hours and a suitable package.

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