Special Educational Needs and Disabilities (SEND) Exceptional Funding Application Form

Special Educational Needs and Disabilities (SEND) Exceptional Funding Application Form
1. SEND Exceptional funding is allocated from the High Needs Block and is reserved for applications from educational settings where children/young people are presenting with exceptional and unexpected circumstances, and their needs have not been fully identified due to unknown factors.
  
  SENDEX is a short-term funding allocation for a maximum of 26 weeks and is a non-statutory funding source.
  
  All applicants from educational settings must provide a fully costed, projected provision map in line with LBH guidance. A template is available: https://www.hillingdon.gov.uk/article/4521/Information-for-professionals
  
  Please refer to the "Guidance and Procedures for Accessing Hillingdon Non-Statutory Funding" which can be found on the Hillingdon local offer website: https://www.hillingdon.gov.uk/article/4521/Information-for-professionals
2. Name of Applicant*
3. Email Address of Applicant*
4. Role of Applicant*
5. Child / Young Person's (CYP) First and Last Name*
6. CYP is also known as
7. CYP's Date of Birth*
8. CYP House name
9. CYP House number*
10. CYP Street name*
11. CYP Town / City*
12. CYP Postcode*
13. Name of EY Setting / School / College (if any)*
14. Date first started school / setting (if applicable)
15. CYP's Year Group (if applicable)*
16. CYP's Unique Pupil Reference Number (Must be provided if in a setting - otherwise state N/A)*
17. CYP's Sex*
  
  Male
  
  Female
  
  Prefer not to say
18. CYP's Sex ANSWER*
19. CYP's Ethnicity*
20. CYP's Ethnicity ANSWER*
21. Broad Area of Need*
22. Broad Area of Need ANSWER*
23. Primary Area of Need*
24. Primary Area of Need ANSWER*
25. Secondary Area of Need*
26. Secondary Area of Need ANSWER*
27. How does the request meet Exceptional Funding Criteria? (Max 1000 characters; additional information can be attached)*
28. Outline of provision already being made from setting / school’s own resources to meet identified needs (if applicable) (Max 1000 characters; additional information can be attached)*
29. How will funding be used? (Max 1000 characters; additional information can be attached)*
30. Is the CYP in receipt of any of the following funding?
  
  Early Support Funding
  
  Early Years SEND Inclusion Funding
  
  EHCP
  
  No Funding in place
31. Is the CYP in receipt of any of the following funding? ANSWER*
32. Are you or the parent / guardian seeking a EHCP needs assessment (EHCNA) for this CYP*
  
  Yes
  
  No
33. If yes, when are you seeking a Needs Assessment (EHCNA)?
34. What evidence have you attached (where available and applicable)
  
  Projected Provision Map
  
  Assess Plan Do Review
  
  Behaviour Log / ABC Charts
  
  SCERTS Assessment
  
  EHCP Application
  
  Professional Reports
  
  Other
  
  None
35. What evidence have you attached (where available and applicable) ANSWER*
36. Please note that all the attachments combined should not exceed 6MB. If a file exceeds the maximum size, please email clearly labelled attachments to saskeywork@hillingdon.gov.uk
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