Tutoring Service Referral Form to be completed by a Professional wishing to refer a Young Carer Tutoring Service "*" indicates required fields The Barnet Young Carers Tuition Service offers our registered young carers (aged 8-24) an opportunity to access a total of 10 sessions of 1:1 tuition in a chosen core subject. The sessions will be offered virtually and will be delivered by our partnership agency, Express Tuition. This service is free for young carers, and funded by Barnet Young Carers. Once the young carers are identified for this service and all necessary forms are completed, all communication will operate directly with Express Tuition. Please note that Barnet Young Carers will still be billed for sessions if children do not attend without giving notice. Therefore we have implemented a strict ‘no show’ policy that will mean your place will be lost if you fail to attend the session without providing 24 hour-notice to Express Tuition. Due to the demand of the service, we have also implemented a referral criteria (detailed below). Our team will carefully review all referrals and offer this service based on priority needs. Anyone who has not been successful in receiving the service will be placed on our waiting list. For any further queries or questions, please contact [email protected] Referral Criteria Children must be registered with us a Young Carer to be considered to receive tuition. Please use this link to be taken to the Professional Referral Form Referrals for this service must be completed by a teacher, school contact or other professional practitioner (such as a social worker) Parents/Guardians and Young Carers must be aware and give consent for referral. Young Carers must have a willingness to engage in this support. Tuition will only be provided to Young Carers who are currently not receiving any other form of tuition/academic support Young Carers must be working towards or below the average academic level in the chosen subject in order to access this service. Referral forms must be completed in as much detail as possible - leaving sections blank may delay the referral process. Acceptance of this referral will be subject to the quality of the referral form and the Young Carers team’s evaluation of Young Carers needs and urgency in relation to this service. Please complete the questions below Name of Professional* Job Title of Professional* Organisation of Professional* Contact No. of Professional*Email of Professional* Please enter your postcode below and click on the Lookup Postcode button Address of Professional City Postcode In what capacity do you know the young person?* How long have/will you be working with the young person?* Name of Young Carer* Gender of Young Carer*-Please select from options-MaleFemaleTransgenderNon-binaryYoung Carer's Date of Birth* DD slash MM slash YYYY Please enter the school's postcode below and click on the Lookup Postcode button Address of School City Postcode Name of School Contact* e.g. Head Teacher/Head of Pastoral StaffContact No. of School Contact*Email of School Contact* Is the young carer due to transition from primary to secondary, please give anticipated date of change and name of new school* Yes No Name of New School Anticipated Start Date DD slash MM slash YYYY Is the young person’s family in receipt of benefits? Yes No Unsure Has the young person presented any of the following* N/A Behavioural/emotional challenges Poor attendance at school Difficulty with concentration Difficulty undertaking exams and testing Other Please Check Appropriate BoxesOther, please give details*Behavioural/emotional challenges, please give more detailsPoor attendance at school, please give more detailsDifficulty with concentration, please give more detailsDifficulty undertaking exams and testing, please give more detailsAny Risk to Tutor?* Yes No Yes, please give details*Does the young person have any SEN or additional needs that we should be aware of? I.e. Autism, Learning Disability, ADHD etc.* Yes No Yes, please give details*Please select the priority subject you would like the young person to be tutored in:* English Mathematics Science Exam Preparation (11+, GCSE, A-levels and SATS) Carer/Employment Support English (as a second language) Study of a Modern Language Please state which modern language the you would like the young carer to be tutored in Please provide details of the level this young person is working at in this chosen subject, and summary of needs (i.e. specific challenges, required improvements)*If the child had an opportunity to be tutored in a second subject, what would this be? Please state:* English Mathematics Science Exam Preparation (11+, GCSE, A-levels and SATS) Carer/Employment Support English (as a second language) Study of a Modern Language Please state which modern language the you would like the young carer to be tutored in You have selected English as the priority and second subjectYou have selected Science as the priority and second subjectYou have selected Mathematics as the priority and second subjectYou have selected Exam Preparation as the priority and second subjectYou have selected Carer/Employment Support as the priority and second subjectYou have selected English (as a second language) as the priority and second subjectYou have selected Study of a Modern Language as the priority and second subjectAre there any other agencies or services working with the young carer to support their academic needs?* Yes No We ask to ensure there is no duplication of services.Speech and Language Therapy* N/A In the Past Current Being Referred Name of Professional Contact No. of ProfessionalEducational Psychology* N/A In the Past Current Being Referred Name of Professional Contact No. of ProfessionalAccess to Learning Mentor/SENDCo* N/A In the Past Current Being Referred Name of Professional Contact No. of Professional1:1 Interventions* N/A In the Past Current Being Referred Name of Professional Contact No. of ProfessionalHomework Club* N/A In the Past Current Being Referred Name of Professional Contact No. of ProfessionalOther (Please mention any other agency(s) if not mentioned above)* N/A In the Past Current Being Referred Name of Agency Name of Professional Contact No. of ProfessionalReasons for Referral*Please include why the Young Carer has been referred to the service and what you and the Young Carer are hoping to achieve as a result of the service. Does the child have a particular method to learning that works for them? Please include as much detail as possible.Does the Parent or Guardian Consent to this Referral?* Yes No Please refer back to Referral Criteria, relating to Parental Awareness & ConsentIs the Young Carer aware of this referral and willing to engage in the tuition service?* Yes No Please refer back to Referral Criteria, relating to Young Carers must have a willingness to engage in this supportCommentsThis field is for validation purposes and should be left unchanged.
