Children and Young People’s Advocacy for School Exclusions
Our advocacy support is open to young people and their families who are facing one of the following;

- Permanently leaving their current school (permanent exclusion or a managed move - being told to go to a different school)
- Suspensions/ fixed term exclusions
- At risk of exclusion (e.g. high no. of behaviour points, lots of internal exclusions)

We are able to support young people who live in or attend a school in North Kensington. 

Please note, we are currently unable to taken on new cases (as of 29/06/2023) due to limited capacity. Please still complete the form, and we anticiapte support can be offered for September. We will contact at the point of referral to update on this. 

If you would like to discuss your case further before making a referal please email earlyintervention@clementjames.org or ring The ClementJames reception: 0207 221 8810

You will get a response within 4 working days

Sign in to Google to save your progress. Learn more
Privacy Statement *
At The ClementJames Centre, we’re committed to protecting and respecting your privacy. In order to process your registration and to provide the best possible service to you we need to collect certain information about you and your circumstances. When you give us personal information, we take steps to ensure that it’s treated securely and confidential. We may need to share some of your information with our funders. This can be either in an anonymised or non-anonymised form. We need to do this for monitoring purposes of the grants they give us to run our services. You can view our full privacy policy on our website: https://clementjames.org/privacy/
Required
Child's Full Name *
Child's Date of birth *
MM
/
DD
/
YYYY
Child's School Year
Child's Postcode *
Child's School (Primary School)
Only complete if the child is currently attending Primary School
Child's School (Secondary)
Only complete if the child is currently attending Secondary School
Please select the category the child falls into: *
Managed move: Where the parent/guardian has been told their child will be moving schools
Please provide some details on the case and the support the young person might need: *
Parent/guardian name *
Parent/guardian phone number *
Parent/guardian email *
Does the child currently have an EHCP (Education & Healthcare Plan)? *
Parent/Guardian Consent *
Please ensure that the parent/guardian has given consent for their child to be refered to ClementJames. Parent/guardian consent is required before we are able to offer support
Required
Referrer's Full Name
If you are making a referal on behalf of a young person you work with please complete this question. If you are a parent/guardian or are doing a self-referal please leave blank.
Referrer's Email Address:
If you are making a referal on behalf of a young person you work with please complete this question. If you are a parent/guardian or are doing a self-referal please leave blank.
Additional Notes
Please use this space if you would like to write any additional information
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of IntoUniversity. Report Abuse
Google Forms