Notification of deletion from roll

This form is used to inform us that a student has been deleted from your school roll. The destination of that child must be known and the appropriate tracking of this child has been completed. If children move out of the country, an address and proof of travel must be seen. This is in line with CME Guidelines

Please also be aware that this does not replace safeguarding procedures. Should you have concerns about a child then you must report these to the first contact team professionals line immediately on 01332 641172 and also the police on 101.

The fields marked with an asterisk (*) are required fields. All the information you enter will be submitted securely.

Referrer's details

* School name

* Your name

* Your email address

* Confirm Your email address

Email addresses do not match.

* Has a home visit been completed to confirm they are no longer at the property?

Yes
No

* Date home visit completed?

* Outcome of home visit e.g. was the property empty?

* Have you discussed this with your school's linked Education Welfare Officer?

Yes
No

* Please explain why not?

Pupil details

* Full name

* Date of birth

* UPN

* Are there any siblings in your school who have also left?

Please select No Yes

* Sibling(s) details (include name(s), Date(s) of birth and UPN(s)

* Grounds for deletion

Please select A - the pupil has registered at another school B - the pupil has not continued at the school after nursery G - The pupil no longer lives a reasonable distance from the school J - the pupil is detained under a sentence of detention K - the pupil has died

* Date removed from roll

* Is the child nursery-aged?

Please select No Yes

* Has the child moved to another nursery?

Please select No Yes

* Name of new nursery

* Has child moved schools within Derby city?

Please select No Yes

* Name of new school

* Date on roll

* Gender

Please select Male Female Other

* Has left the UK?

Please select No Yes

* Compulsory school age 5+?

Please select No Yes

* Ethnicity

Please select White British White Irish Other White background Dual Heritage - White and Black Caribbean Dual Heritage - White and Black African Dual Heritage -White and Asian Dual Heritage - Other Asian or Asian British - Indian Asian or Asian British - Pakistani Asian or Asian British - Bangladeshi Asian or Asian British - Other Black or Black British - Caribbean Black or Black British - African Black or Black British - Other Chinese Roma Unknown Other

* SEN status

* Has the child a disability?

No
Yes

* Disability details

* CP status

Please select Current Historical None

* CP details

* Full name of parent/carer

* Telephone number

* Address

* New address

* Has the appropriate removal from roll letter been sent?

No
Yes

* Have you confirmed that they are no longer at the property?

No
Yes

Date living at new address

Date of start at new school

Are there any other agencies involved?

Social care
YOS
MAT
EYS
Health concerns
SEN
Other

* Agency details

School name in new local authority/new local authority admissions department

* School name/admissions

* Contact(s) made

Phone call
Email
Admissions contact

* Details of contact(s) made

Date pupil record transferred