Any section highlighted in blue is the responsibility of the Social Worker to fill out.
Any section highlighted in yellow is the responsibility of the Education Setting to fill out.
This form contains 4 pages – please ensure all information is completed as fully as possible. Failure to do so will result in delays in finalising the document and any payments owed.
Primary PEP
This is my termAutumn/Spring/Summer
Details of Child:
Family Name / Given Names
Actual DOB / Gender
Ethnicity / Primary Language
Case Number
Age
UPN
School Year
This PEP Meeting Date
Date set for next PEP Meeting
Is this my initial PEP OR the first PEP since the move to a new education setting or school OR are there any changes in my carer details since my last PEP? / Yes/No
Are there any planned transitions this academic year? / Yes/No
Current Care/Placement Details
Name of Carer:
Should their address be restricted? / Yes/No
My carer's address:
My carer has delegated authority/give signed consent for / / Education setting school day trips
/ Education setting school trips up to 4 days
/ N/A
My social worker has delegated authority/give signed consent for / / Education setting school day trips
/ Education setting school trips up to 4 days
/ N/A
My parent(s) have delegated authority/give signed consent for / / Education setting school day trips
/ Education setting school trips up to 4 days
/ N/A
Who should be invited to my parent/s evening / / Parent/s
/ Carer/s
/ N/A
Who should receive copies of my education setting/school reports / / Parent/s
/ Carer/s
/ Social Worker
/ N/A
Who should the school/education setting contact in an emergency? / / Parent/s
/ Carer/s
/ Social Worker
/ N/A
Additional notes for delegated authority
Care Status:
Date into care:
Date Started Current Placement:
My Personal Education Plan
My School/Education Setting is:
My Designated Teacher/Person is:
Their Telephone number and Email is:
My Headteacher is:
(Please note we must have the headteachers contact details for any pupil premium plus requests to be approved)
Their email address is:
My Key Person is:
(‘Which adult do I spend time with at school?’ e.g. My class teacher, a learning mentor etc.)
Their email is:
My Social Worker is:
Their Telephone Number is:
PEP Meeting
People who attended my meeting
Name / Their Role / How to contact them
About Me
Special Educational Needs
(If young person does not have SEND needs please select ‘none’ in the first column below.)
Special Educational Needs/Disability Status
None
Additional SEND Support
Top up funding
EHCP
Statement
SA
SA+ / Area of need
N/A
Cognition and Learning
Communication and Interaction
Social, Emotional and Mental Health
Sensory and/or Physical
The top 3 things I want you to know about me, including any achievements in and out of school
1)
2)
3)
My aspirations and future plans - when I am older and finish school I would like to…
What/ who in school will help me?
Attendance and Progress
Attendance
Overall Percentage / Percentage of absences authorised: / Percentage of absences unauthorised: / Are there concerns over my attendance? / Details of Concerns / Number of fixed term exclusions / Number of internal exclusions
Yes/No
Is the child/young person accessing full entitlement? Yes/No
If the answer is no, please indicate the following:
Number or hours accessed: / Reason for reduction:
Plan to increase provision: / Timescale:
Alternative Provision
Is the child/young person accessing alternative provision? Yes/No
If the answer is yes, please indicate the following:
Where: / When:
Expected outcomes:
Progress towards outcomes:
Name and contact details of person responsible for quality assurance:
Attainment
Type of course
(e.g. SATs, Teacher Assessment) / Previous school assessment / Current school assessment / End of Key Stage target / Am I on track to achieve national expectations? / Am I making expected progress from my starting point?
Phonics / Yes/No / Yes/No
Reading / Yes/No / Yes/No
Writing / Yes/No / Yes/No
SPAG / Yes/No / Yes/No
Maths / Yes/No / Yes/No
NB: The questions below must be filled in for those young people who are in reception and above.
Overall am I on track to achieve Age Related Expectations (ARE)? Yes/No
Overall am I making expected progress from my starting point:Yes/No
Are there concerns over my school place?Yes/No
Please include below anyrelevant information shared prior and during my meeting.
Next Steps
NB: Targets can be either learning or pastoral
Previous ‘SMART’ target / Has this been met? / Was Pupil Premium Plus (PP+) accessed?
Yes/No / Yes/No
Yes/No / Yes/No
Yes/No / Yes/No
Targets are needed for:
(Please complete these in the next column) / Current SMART target details below:
(These must relate to subjects in first column) / Is PP+ requested this time?
/ Details of request (if applicable) / Expected outcome
for this
intervention / Cost per hour
(Please only enter figures) / Hours per week
(Enter part hours in decimal e.g. 15 mins = 0.25) / Cost per term
(Please only enter figures)
Reading / Yes/No
Writing / Yes/No
Maths / Yes/No
Other subject (if applicable) / Yes/No
Pastoral (if applicable) / Yes/No
Contact details for the Virtual School:
Tel: 01244 976172
Email: