School referral form

Please complete the 5 part form below.

School referral form
  • Part 1. Student details
  • Part 2. School details
  • Part 3. Academic progress
  • Part 4. Medical
  • Part 5. Agreement and checklist

Part 1. Student details


Parent / guardian / carer details


Second emergency contact



Part 2. School details


Safeguarding lead


Attendance contact


Finance contact


Part 3. Academic progress

Please provide the latest school progress report including current and predicted grades for the student


English


Mathematics


Navigators academic framework is designed around Functional Skills

Please describe what level you believe the student should enter the programme (baseline assessments will be carried out in the first few weeks of engagement)


What are your expectations for the student whilst at Navigators?


Part 4. Medical

Does the student have any of the following conditions / allergies?


If yes, the student must have their inhaler with them at all times

Medication


Part 5. Agreement and checklist


Days per week



Navigators operate a payment in advance policy


By submitting this application form you are agreeing to the terms of the commission agreement and payment requirements. 

Document upload checklist:

  • Latest school progress report
  • EHCP
  • Risk assessment
  • LAC review
  • PEP
  • Social care reports
  • Education psychologist report

Failure to provide these may result in a delay in the offer.