Young Person Referral Form - for schools and local authorities
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    Click the link below to refer a young person

    https://form.fillout.com/t/1wakAAMTGbeu

    You can always email referrals@targetedprovision.com or call us on 020 7661 7026

  • Young Person Referral Form - for schools and local authorities

  • Call us on 020 7661 7026 if you are not able to complete this form or have any questions.

    If you want to save and come back to the form later, select "Save " at the bottom of the form. It will ask you to sign in or register for Jotform. This is optional and you can skip this step by selecting "Skip Create Account".

  • Your contact details

    Please do not enter the young person's name
  • Please do not include special characters in the institution name (e.g. * / - )

  • Young person details

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  • Profile of the young person:

    Kindly include as much information as possible about the young person's needs and any relevant information about them or regarding their education to date.
  • Supporting documents

  • Upload EHCP
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  • Upload PEP
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  • Upload YPRA
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  • Browse Files
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  • Browse Files
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  • Browse Files
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  • Browse Files
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  • Information about where the tuition will take place

  • Weekly progress reports

    You will receive a PDF each week detailing the young persons lesson reports including engagement, attendance and progress. We are not able to send reports directly to parents/carers, however if other professionals need access to weekly reports (for example class teachers) please enter these below.
  • Primary contact details

    The primary contact is the person responsible for and who will oversee their sessions with the tutor. In most cases, this is the young person's parent, carer, school teacher or guardian. We will get in touch with them to coordinate the date/time/logistics of sessions. Their details will also be passed on to the tutor.
  • ⚠️ You have entered your email address. Is this correct?

  • Thanks for confirming that you are the primary contact for {youngPerson12}

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  • Details about the support required

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  • Educational Level:
    We appreciate in some instances you will have little indication of a young person's working age, in this instance please select the highest level you think the young person could be working to, and add any further information to the pupil profile.


  • Targeted Provision programmes

    In addition to the bespoke packages of support we put in place, we offer some programmes to target specific areas of need.

     

    1) EAL for beginners: This is is programme designed to support young people who are new to the country and do not yet have school / college places. Tutors will teach basic English skills and support young people to make progress in speaking, listening, reading and writing.

    2) Metacognition: Tutors use resources and methods to help young people understand how they learn best, and support them to develop study skills. Most suitable for Years 6 and 10/11.

    3) Life Skills: Tutors provide young people with support to consider careers and further education opportunities, as well as some guidance on managing finances, CV writing, and attending interviews. 

    4) Functional Skills exams (Levels 1 and 2, English and Maths): We are a functional skills exams centre, so can arrange for young people to sit these qualifications. The cost is £199 for one qualification and £390 for two. We will provide further information upon receipt of referral if you select this option.

  • Our teachers

    Generally all of the tutors that we provide for referrals hold QTS, however we know that for some young people, a tutor or mentor with SEND specific or youth work support may be more suitable. We will only ever select a tutor, QTS or non QTS, who has the right experience to meet your young person's needs.

  • Additional comments regarding hours (optional)

  • ✅ You will receive a PDF version of the completed form via encrypted email after submitting

  • ✅ You will receive a PDF version of the completed form via email after submitting

  • When you click submit, a receipt will be sent to the referral email address - {yourEmail70}

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