EDUCATION LEEDS - DOC

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					                                                                        APPENDIX C

                         Exceptional Needs Funding Request Form

                                 Data Collection
                    Summary sheet 20___ to 20___ academic year

Name:                         Year group:              School:

Main needs requiring EN support:




Progress made in 20___ to 20___ academic year


Focus of additional input             Progress made?              Key staff


   Teaching new skills



 Establishing/reinforcing
 appropriate behaviours


  Reactive management




Plans for 20___ to 20___ academic year


Focus of additional input                   Aims                  Key staff


   Teaching new skills



 Establishing/reinforcing
 appropriate behaviours


  Reactive management




                                            Page 1
       Exceptional Needs Funding Request Form

                  Data Collection
          Team around the child - log sheet


Name    Role           Date of last           Nature of last
                      Involvement             Involvement
                        involvement




                        Page 2
                         Exceptional Needs Funding Request Form

                                            Data Collection
                                          Annotated timetable

Please include an annotated timetable that indicates the following information:
    Lessons/subjects
    Group/class size
    Staffing for main group
    EN provision for the pupil

Do this in a way that suits your planning. Examples are provided below.

Example 1

Pupil A is KS2. Usual class size is 16 but the group is split for numeracy. Class teacher is AB. Support
staffing varies. The class operates a 3 session day.

Day           Session 1                      Session 2                         Session 3
              Lesson: Literacy               Lesson: Numeracy                  Lesson: DT
Monday
              No. in group:    16            No. in group:    8                No. in group:   16

              Class support: AB, CD          Class support: AB                 Staff for group: AB, CD

              Location: Room 6               Location: Room 6                  Location: Room 6

              EN staff: EF                   EN staff: CD EF                   EN staff: EF

              Times of input: 9.30 -10.30    Times of input: 11.00-11.30       Times of input: 1.30-3.30

              Location: Room 6               Location: Room 2                  Location: Room 7

Example 2

Pupil B is in KS3. Usual class size is 14. The class follows a subject based timetable where subject staff
vary. Support staff are reasonably constant (GH and JK). Pupil B accesses some subjects.


Day        Session 1          Session 2           Session 3          Session 4          Session 5

       Lesson:                Lesson:             Lesson:            Lesson:            Lesson:
Monday Literacy               Numeracy            PE                 IT                 Science

           Class support:     Class support:      Class support:     Class support:     Class support:
           GH                 GH                  EF                 GH                 JK

           EN staff:          EN staff:           EN staff:          EN staff:          EN staff:
           EF JK              EF                  GH JK              JK                 EF GH

           Location:          Location:           Location:          Location:          Location:
           Withdrawal         In-class            In-class           In-class           In-class




                                                    Page 3

				
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