Please confirm:
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Our Therapeutic Educational Support is for children and young people who have experienced trauma in and around education, and it includes support outside of school such as Enrichment activities and our Primary Youth Club, support for children currently unable to access mainstream education, including Therapeutic Education tutoring and mindfulness sessions available through our Alternative Education Provision.
I am a parent/carer making an enquiry for Therapeutic Educational Support
Parent/Carer Name
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First Name
Last Name
Email
Phone
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(###)
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Address
Child's Name
First Name
Last Name
Date of birth
MM
DD
YYYY
Gender and pronouns
Ethnicity
Asian or Asian British (Indian, Pakistani, Bangladeshi, Chinese, any other Asian background)
Black, Black British, Caribbean or African (Caribbean, African, any other Black British, or Caribbean background)
Mixed or multiple ethnic groups (White and Black Caribbean, White and Black African, White and Asian, any other Mixed or multiple ethnic background)
White (English, Welsh, Scottish, Northern Irish or British)
White (Irish Gypsy or Irish Traveller, Roma, any other White background)
Other (Arab, Latino, any other ethnic group)
Prefer not to say
Main language spoken
Address (if different to parent/carer above)
Child's school and address (if applicable)
Main school contact (if applicable)
Does your child have an EHCP?
Yes
No
If yes, please describe your child's needs
Is your child eligible for pupil premium?
Yes
No
Not sure
Is your child eligible for free school meals?
Yes
No
Not sure
We’d like to know as much about the reason you’re getting in touch with us as you’re comfortable sharing here. Please know you’re also welcome to call us, email us any other forms where it might be written down, or put “call back” in the box below and we’ll reach out for a conversation.
Has your family accessed any support in the past?
Are you accessing any other services?
Please can you tell us about your child's strenghts and any activities they might enjoy doing?
Have you visited any of our wellbeing hubs?
Before submitting this form, please ensure that you have read and agree to Cambridge Acorn Project’s Terms of Service (available at the bottom of this page)
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By ticking yes and submitting this form your are confirming that:
• You have parental responsibility
• You agree to share the information provided in this form with Cambridge Acorn project and are aware that Cambridge Acorn Project will safely store this information.
• This form contains accurate information.
• You consent to Cambridge Acorn Project delivering services in response to your enquiry (when applicable)
• You agree to Cambridge Acorn Project’s Terms of Service
If you do not agree, please do not submit this form.
Yes, I consent
Please type your name
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Submission date
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MM
DD
YYYY