PUPIL REFERRAL UNIT APPLICATION TO CONVERT TO AP ACADEMY STATUS
(PLEASE COMPLETE ALL RELEVANT FIELDS WITH INFORMATION OR AN "X")
1. Basic Details
Name of PRU and full postal address
Local Authority & LA/ESTAB number
Name of Head Teacher
Email address
Telephone number
Name of Chair of Management Committee
Email address
Telephone number
Name of the main contact for the conversion process / Include role, email address and telephone number if the main contact is someone other than the Head Teacher or Chair of Management Committee
2. Conversion Date
Please state your preferred conversion date / DD/MM/YYYY
3. Single AP Academy or a Academy Chain
Are you applying in a chain? / Yes / No
If No, please move on to section 4
If applying in a chain, please indicate which type? / Multi Academy Trust / Umbrella Trust / Collaborative
Partnership
Is the intention to join an existing Trust or to create a new one? / Please also mention the name of the existing Trust or the proposed name for the new Trust
What are the names of the other schools / PRUs in the chain?
Please provide brief details of the rationale for this arrangement and the benefits you expect it will bring?
4. Pupils
Age range / [Youngest] - [Oldest]
Type / Approx. Percentage (%)
Permanent exclusion
Fixed period exclusion
Early intervention to improve behaviour
Medical referrals
School age mothers
Other (please specify)
Full Time Equivalent (FTE) pupils
Physical capacity at premises
Number of pupils recorded in the last census
Number of places for 2014/15
(as agreed with LA)
Does the number of agreed places include places commissioned by schools? / Yes / No
Breakdown of places
AP
(total places within Pre-16 High Needs Block) / SEN Unit
(any places in a LA-designated SEN unit/resourced provision) / Hospital education places
(any places that are direct referrals by a medical practitioner) / Post-16
(any places that fall within post-16 element)
5. Performance
Ofsted ratings
Date of most recent Ofsted inspection
Overall rating in most recent Ofsted inspection
Key judgements / Rating
Achievement of pupils
Quality of teaching
Behaviour and safety of pupils
Leadership & management
GCSE (if dealing with KS4 pupils) / 2012 / 2013 / 2014
5+ A*-C GCSEs (including English and maths) / % / % / %
5+ GCSEs or equivalent at A-G / % / % / %
KS2 (if dealing with primary aged pupils) / 2012 / 2013 / 2014
Level 4+ in English / % / % / %
Level 4+ in maths / % / % / %
Pupil progress / 2012 / 2013 / 2014
KS2 to KS4 progress in English / % / % / %
KS2 to KS4 progress in maths / % / % / %
Attendance / 2012 / 2013 / 2014
Overall attendance rate / % / % / %
Persistent absence at 15% / % / % / %
Pupil Destinations (approximate breakdown) / 2012 / 2013 / 2014
Back to mainstream education / % / % / %
Training / % / % / %
Employment / % / % / %
NEET / % / % / %
Other (please specify) / % / % / %
Total / 100% / 100% / 100%
Please provide below a brief summary on quality and pupil outcomes
(i.e. systems to reintegrate into mainstream education, sharing systems used between schools, how pupils’ needs are assessed, how personalised programmes are developed, etc.)
6. Finances
Does your PRU have a fully delegated budget? / Yes / No
If No, how is the PRU currently funded?
Please provide details of therevenue carry forward at the following dates:
31 March 2014
(i.e. the end of last financial year) / On planned date of conversion / 31 March 2015
(i.e. the end of this financial year)
Please provide details of the capital carry forward at the following dates:
31 March 2014
(i.e. the end of last financial year) / On planned date of conversion / 31 March 2015
(i.e. the end of this financial year)
If the PRU has a revenue or capital deficit, including in-year deficits, where the balance is lower at the end of the current year, than at the end of the previous year, please provide a summary of how the deficit is being handled (please also see the guidance note at end of this form for details on how deficits will be assessed).
Does your PRU have any outstanding loans? / Yes / No
Is your PRU part of a PFI scheme? / Yes / No
Is your PRU part of a BSF contract? / Yes / No
If there are any existing loans, please provide details including who the loan is with, how much it is for and for how long.
If part of PFI, please provide details here: e.g. land/buildings or in relation to ICT, name of company, length of contract etc.
Please provide information on commissioners of Places
Commissioner / Approx. percentage of places commissioned
Local authority / %
Mainstream schools / Academies / %
Other (please specify) / %
Please provide details of your agreed Top-Up funding rates? / £
What is your PRU’s Per Place cost? / £
Please provide information on any additional funding not included in budget from LA (e.g. from clusters of schools, from grants)
How much is being received?
Who provides the funding?
What agreement covers this?
Will this funding continue post-conversion? / Yes / No
If Yes, for how long and under what agreements/arrangements (e.g. Service Level Agreement with schools)
Provide information on staffing at the PRU
Please state number of staff employed by the PRU
How many members of staff work full-time for the PRU?
How many members of staff work part-time for the PRU?
Is the intention that all staff would transfer to the Academy on conversion?
7. Land and Buildings
[NOTE: if the PRU operates from more than one site, please answer all the questions of this section for each site]
Site name / Owner of land and buildings / Proposed method for land transfer
(e.g. LA, NHS, etc.) / (e.g. intend to agree 125 year lease with LA for continued use of site post-conversion)
Are any of the sites privately rented? / Yes / No
If yes, please provide details of arrangements below, including the amount paid per annum and how this is funded?
Are any construction / building works planned for the PRU or are there any building works that will be underway at the planned conversion date? / Yes / No
Are there any community / educational groups that use the premises / land (e.g. shared sports facilities, shared kitchen/dining area, etc.)? / Yes / No
If Yes to any of the above, please provide details here:
Are there any other building or land issues which may be relevant? / Yes / No
If Yes, please provide details here:
8. Additional information
Is the PRU part of an LA reorganisation? / Yes / No
Is the PRU part of any LA closure plans? / Yes / No
If Yes, please give details
Please confirm that the Management Committee has discussed the statutory consultation exercise and considered any equality assessment needs
Please provide brief details of your plans for consultation with stakeholders, including proposed start and end dates, who is being consulted and how this will be done
We encourage well-performing PRUs to share their expertise by becoming a sponsor. Would your PRU be interested in finding out more?
Please provide any other information you think may be significant for the conversion to AP Academy status.
Please provide details of the current constitution of the Management Committee
Category / Number
Community members
LA members
Staff members
Parent members
Other (please specify)
Please provide some brief details on how you propose to restructure the governance on conversion.
9. Academy Support Grant
Please provide the PRU or Trust’s bank details below so we can pay the support grant promptly following the award of an AP Academy Order. To claim this grant, you must agree to the terms of the support grant as set out in the “Support Grant Claim Form” on our website. Please indicate you have read and agree the terms by putting a cross in the box below (claims that do not include this will not be processed and you will not be paid).
I confirm I wish to claim the support grant and I agree to be bound by the terms of the support grant certificate
Amount being claimed
(please put X in relevant box below)
£25,000
Single site PRU / £30,000
PRU on two sites / £35,000
PRU on 3 - 4 sites / £45,000
PRU on 5+ sites
Name of bank
Bank branch address
Bank account name
Sort code
Account number
10. Declaration of the Management Committee
By submitting this application we, the management committee of the PRU named in this application confirm that:
- we have the authority to resolve that our PRU should become an AP Academy;
- all the information included is true and accurate to the best of our knowledge;
- the Management Committee has voted in the majority in favour for conversion to AP Academy status;
- a resolution to apply to convert to AP Academy status has been held and carried and a record of this decision is available should Departmental officials wish to see it;
- we will, in accordance with Section 5 of the Academies Act, consult with any stakeholder we consider relevant to our conversion and also consider any equality needs, and that this consultation will be completed before we sign our Funding Agreement;
- there are no financial or safeguarding investigations on-going at our PRU;
- we accept that the Department may ask for any additional information as they see fit to assess our application and that as a condition of our conversion we shall provide it;
- should any information presented in this application be revealed to be false or misleading, our application may be rejected and our Academy Order potentially rescinded if it has already been awarded.
Name and position of the person that completed this form / [please insert name], [please insert position held]
Date form was completed / DD/MM/YYYY
Guidance Note on Completing the Application to Convert to AP Academy Status
1.Basic details
Please state the fullregistered name of the PRU, its address, the local authority name and the LA/Estab number so that we can correctly identify the establishment.This information can be found on EduBase at
We require the name and contact information of the head teacher and of the Chair of the Management Committee. It would also be helpful to confirm who the main person is to contact during the conversion process. For example, if it is the business manager or a consultant, please provide that person’s name and contact details.Please ensure that the main contact email address is appropriate for receiving sensitive or official documentation. Private email addresses (for example, Hotmail, Gmail, Yahoo accounts) are not appropriate. If these are provided as the main address, we will ask for an alternative official or business account to be supplied.
2.Conversion date
We can convert a PRU on the first day of any month but this would take around 6 months to complete from receipt of application to opening.However, if the PRU is part of a PFI contract, it may take longer. Your project lead will discuss this with you in more detail.
3.Single AP Academy or Academy Chain
We need to know whether you wish to convert as a single AP Academy or in a chain with other PRUs and/or mainstream Academies/Special Academies. PRUs that are performing well can convert as a single AP Academyor form a chain (i.e. a Multi-Academy Trust, an Umbrella Trust or a Collaborative Partnership) with other Academies, but they may also wish to express an interest in being sponsored.
If your PRU is converting as part of an Academy chain, we need to know the type of chain; the names of the PRUs/schools that you are converting with and the names of any existing trusts / partnerships. If you are joining a large established chain (or more than 6 schools) we would not expect you to name all of the schools.
4.Pupils
With regards to the full time equivalent (FTE), please provide the FTE figure for part-time pupils over the full academic year. For example, a pupil attending two full days a week throughout the academic year would be the equivalent of 0.4 full-time pupils. Or, if you have 15 pupils who attend for one day a week for a term, that counts as 1 FTE.
5.Performance
We take a PRU’s attainment data into account when assessing its application to convert.
6.Finances
The finance section is particularly important and must be completed accurately to avoid delay to your application being processed.
Please state the revenue and capital carry forward for the PRU at three points in time: the end of the previous financial year, the end of the current financial year and the point at which you intend to convert.
Please make it clear whether the amount at each point is a surplus or a deficitby writing the appropriate words in brackets after the figure.
If the PRU has a deficit, we need to know how this occurred and how long the PRU has been in this position. This should include an explanation of in-year deficits, i.e. where the school’s balance at the end of the current financial year is lower than it was at the end of the previous financial year.A deficit does not prevent your application being considered or approved, however we need to be assured that:
- the plan you have to reduce the deficit is workable
- the deficit will be eliminated within a short period of time
- that there is no longer term financial problem with the PRU that will mean a deficit will re-occur
PRUs withlarge deficits will be asked to supply budget forecasts showing their current expenditure and how they expect to reach a balanced budget within 2-3 years. The Department's preferred format for that information is for income and expenditure to be set out using the Consistent Financial Reporting codes.
It would be helpful to know whether the PRU is currently part of, or is planning to join a PFI scheme - if this is the case your project lead will contact you for further details and explain the process to you.
If the PRU has any outstanding loans please state the full amount, who they are with, and outline the repayment schedule.
“Hospital education”means education provided at a community special school or foundation special school established in a hospital, or under any arrangements made by the LA under section 19 of the 1996 Act (exceptional provision of education), where the child is being provided with such education by reason of a decision made by a medical practitioner and “hospital education places” shall be read accordingly.
- Land and Buildings
If the PRU operates from more than one site, all the questions of this section should be answered for each site on a separate sheet.
We also need to know whether the premises are used for example by youth groups in the evening or at weekends, or if, for example, neighbouring properties have a right of way through the land.
8.Additional Information
Please indicate whether the PRU has been included in any local authority plans for reorganisation or has been considered as part of the local authority’s closure plans. Please note that we will corroborate this information with the local authority and will need to discuss the situation with you as part of the application process.
We would like confirmation that the Management Committee has considered what plans you have for the statutory consultation and any equality impact assessment you will undertake. These need to be completed before the conversion date.
In this section you may also supply any other information that you consider relevant to your application or you think may be significant. For example, you may wish to tell us if you are planning expansion, etc.
9.Academy Support Grant
In order to access the support grant, please mark the box to confirm agreement to the terms of the grant and provide the bank details for the PRU/Trust.
10.Declaration of the Management Committee
Please make sure that the Management Committee has read and agrees to the declaration before sending the application form to the Department. The person who completed the form should insert his or her name and post and also the date the form was completed.
Please email the completed application form (in Word format) to:
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