Fill - Free fillable Make a reference (12-15 years) form (Scotland Health & Education Chamber) PDF form

This form can be completed by children aged between 12 and

15 years, who want to make a reference to the Additional

Support Needs part of the Tribunal - we call this “the Tribunal”

in this form.

Make a Reference

Page 1 of 13

Hello!

Welcome to the Additional Support Needs part

of the Tribunal. We call this “the Tribunal” in

this form. You can check our “needs to learn”

website (coming soon) for word meanings and

other help.

You are not on your own. The Tribunal’s staff are

here to help you.

There are two types of reference you can make to the Tribunal:



A co-ordinated support plan (CSP) type; or



A reference appealing against your education

authority’s decision about your capacity or

wellbeing.

To do this, please fill in this form.

If you think you have not been treated fairly at school

then you can make a Claim.

To do this, you will need to fill in the “Make a Claim”

form which is available on our “needs to learn”

website at this link

To help you fill in this form please read the Children’s

Guide on How to Make a Reference which is

available here.

Page 2 of 13

Your Contact Details

So that we can contact you about your reference

please tell us your:

Name:

Date of Birth:

Address:

Telephone number:

Mobile:

Email address:

The law says that the Tribunal can only send certain

information by email. The Tribunal may need to send

you information by post.

Page 3 of 13

Your Parent/Carer/Guardian’s

contact details

You don’t have to tell us this, but it helps us, if

your parent/carer/guardian decides to come to the hearing.

Please tell us your parent, carer or guardian’s contact details.

Name:

Relationship to you:

Address:

Telephone number:

Mobile:

Email address:

Your Education Authority

Which Education Authority is your reference about?

Name of Education Authority:

Name of contact person at Education Authority:

Address:

Town/City:

Postcode:

Telephone number:

(If you are not sure what an Education Authority is

then please read page 7 of the Guide on How to

Make a Reference before completing this section.)

Page 4 of 13

Your Additional Support Needs

Some children need extra help at school so they

can get the most out of their education. This is

called having additional support needs.

Explain what your additional support needs are:

There are lots of reasons why you might have

additional support needs. Please read page 8 of the

Children’s Guide on How to Make a Reference for

more information.

Page 5 of 13

Your Reference

You must send this form to the Tribunal within 2 months from

the date of the decision or failure that your

reference is about.

To understand more about the different types of

references you can make and what information

the Tribunal wants to know please read page 9

of the Children’s Guide on How to Make a

Reference.

Explain what your Education Authority has done (or not done)

which you disagree with and why you want to make a

reference:

Page 6 of 13

Page 7 of 13

Your Supporting Information

Please enclose any documents you think would

help the Tribunal to understand your reference.

Is there anything else which you would like to tell the

Tribunal to help them understand your reference?

You can write here the name and contact

details of any people (we call them

“witnesses”) you want to speak to the

Tribunal.

Please tell us their name, the position

they work in and their address + phone

and email details.

Page 8 of 13

Your Voice!

Your voice, feelings and opinions matter.

The Tribunal will do its best to help you

overcome any difficulties that you have when

making your reference.

Please tell us if you have communication difficulties or other

support needs.

What can the Tribunal do to help you with these during the

hearing?

Page 9 of 13

Page 10 of 13

Your Representative

To help make sure the Tribunal hears your views,

you have the right to have someone who will act

as your representative.

Please tell us your representative’s contact details:

Name:

Job Title:

Organisation:

Address:

Telephone number:

Email address:

Page 11 of 13

Your Supporter

As well as a representative, you can have

someone attend the hearing with you, to support

you.

If you want more information about the role of a

representative or a supporter, or you do not have a

representative or supporter, please see pages 12

and 13 of the Children’s Guide on How to Make

a reference.

Please tell us your supporter’s details

Name:

Address:

Telephone number:

Email address:

Last bit

Please read over the form and check that you have answered

all of the questions.

Once you have completed the form please sign here:

Your signature

Date

Thank you for filling in this form.

You need to send this form and all supporting information to

the Tribunal. You can do this by email or post.

Our contact details are:

Additional Support Needs, Health and Education Chamber

First-tier Tribunal for Scotland

Glasgow Tribunals Centre

20 York Street, Glasgow, G2 8GT

email: ASNTribunal@scotcourtstribunals.gov.uk

Page 12 of 13

What happens next?

We will read your form to see if the Tribunal can help with the

matters you have raised.

We will then contact you to update you on what will happen

next and, if necessary, ask you for more information.

For more information about what happens next,

please visit our “needs to learn” (coming soon)

website which has lots of useful information.

If you have any questions you can contact us on:

0141 302 5860.

Page 13 of 13

Download
Save PDF to desktop

Email
Email completed PDF

Send for Signing
Email for others to sign

Print
Print document

NAME

Make a reference (12-15 years) form (Scotland Health & Education Chamber)

View Audit Log
Print With Audit Log
Duplicate Document

Fill Online, Printable, Fillable, Blank Make a reference (12-15 years) form (Scotland Health & Education Chamber) Form

Related forms

Fillable Make a reference (12-15 years) form (Scotland Health & Education Chamber)

Fill Online, Printable, Fillable, Blank Make a reference (12-15 years) form (Scotland Health & Education Chamber) Form

Related forms

First 20 documents completely FREE!