Elective Home Education School Exit Information

This form should be completed and returned to Elective Home Education (EHE) with a copy of the withdrawal/de-registration letter from parents, an attendance certificate and a copy of the last report.

The purpose of this form is to gather information on students being de-registered from the school roll to be educated at home. Please complete as fully as possible.
Child details
Name of child

First name

Last name
Date of birth
NCY
Is this child a carer?
YesNo
Address

Address Line 1

Address Line 2

City

County

Postcode

Country
Name of parents/carers with parental responsibility
Telephone number/s
Mobile/s
Parent/s email address

School Details
Name of school
Names of school aged siblings if known
Date school received withdrawal letter from parents/carers
Attendance
Date last attended school
Have you discussed home education with the family?
YesNo
Did anything happen in school which may have led the parents to take this decision

In your opinion what is the main reason the parent is withdrawing their child to home educate them?
Does the child have special educational needs/support in school?
EHCNA/EHCPSEN supportNone
Please provide details of any support provided
If EHCP name of SEND keyworker
Last EHCP review date

When was the child’s most recent school assessment and what levels did they attain?
Please provide a brief description of learning concerns/positives
Has the child had any fixed term exclusions in the current academic year?
YesNo
If so, please attach details

Are any other agencies involved with the family and if so, who is involved?
Please provide details of any safeguarding concerns you may have or any other relevant information
Does the school have any concerns about the parents’ ability to provide a suitable education for this child? If yes, please give details
Do you know of any reasons why this family should not be visited by a lone member of staff?
Has the school made an offer of support to the child or parent e.g. examinations/learning resources? If yes, please specify
Any other comments we should be aware of