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



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


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.