1Page 1 2Page 2 3Page 3 4Page 4 5Page 5 6Page 6 7Summary Progress Page 1 Introduction Children missing education (CME) are children of compulsory school age who are not registered pupils at a school and are not receiving suitable education in another setting – either privately or at home. When to use this form Where there is a concern that a child’s safety or their wellbeing is at risk, it is essential to take action without delay – these cases should be referred to Careline. If you know of a child who is missing education please use this form to refer them to our CME Team for tracking and support. Child/young person's details First name Last name Gender Male Female Date of birth Year group (optional) -- Please Select -- Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Ethnicity (optional) -- Please Select -- White British Irish Gypsy or Irish Traveller Any other White background White and Black Caribbean White and Black African White and Asian Eastern European Any other Mixed / Multiple ethnic background Indian Pakistani Bangladeshi Chinese Any other Asian background African Caribbean Any other Black / African / Caribbean background Arab Any Other Ethnic Group Not known at this stage Unique pupil reference number (optional) Do you know the child/young person's current address? Yes No Is the current address in the UK? Yes No Current Address Current postcode (optional) Last known UK address Last known UK postcode (optional) Is the child/young person on a school roll? Yes No Don't know School name Last school name Do you know when the child/young person was removed from the roll? Yes No Date removed from roll Reason for removal from roll (optional) Do you know the date the child/young person last attended school? Yes No Date of last attendance Does the child/young person have any Special Educational Needs? Yes No Don't know Do they have a statement or Education Health Care Plan? Yes No Don't know Is the child/young person looked after by the local authority? Yes No Don't know No information is required, please proceed to the next page. Page 2 Siblings Are there any known siblings of compulsory school age? Yes No Please enter the details of any siblings of compulsory school age First name Last name Gender Male Female Date of birth Year group (optional) -- Please Select -- Reception Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Is the sibling missing/at risk? Yes No Don't know If yes, please give details (optional) Ethnicity (optional) Same as primary child/young person Don't know White British Irish Gypsy or Irish Traveller Any other White background White and Black Caribbean White and Black African White and Asian Eastern European Any other Mixed / Multiple ethnic background Indian Pakistani Bangladeshi Chinese Any other Asian background African Caribbean Any other Black / African / Caribbean background Arab Any Other Ethnic Group Current or last known UK address (optional) Current or last known UK Postcode (optional) Current or last known school (optional) If removed from school roll, when? (optional) If known, date of last school attendance (optional) Does the child/young person have any Special Educational Needs? Yes No Don't know If yes, do they have a statement or Education Health Care Plan? (optional) Yes No Don't know Not applicable Is the child/young person looked after by the local authority? Yes No Don't know Add another sibling No information is required, please proceed to the next page. Page 3 Parent/Carer's details Are there any parent/carer's details to be added? Yes No Please give details of all known parents/carers First name Last name Relationship to child/young person Address (optional) (if different from child/young person) Postcode (optional) (if different from child/young person) Email address (optional) If English is not the parent/carer's first language, will be need to use the services of a translation if we visit them? Yes No Not applicable If yes, parent/carer's first language (optional) Any other relevant information about the parent/carer (optional) add another parent/carer No information is required, please proceed to the next page. Page 4 Other contacts' details Are there any other contacts you have for the child/young person that might be able to assist in our enquiries? e.g. emergency contacts, grandparents etc. Yes No Contact details Contact name Contact's relationship to child/young person Contact details Add another contact No information is required, please proceed to the next page. Page 5 Referral details Reason for referral -- Please Select -- Moved away - within UK Moved away - outside UK New to area Not returned from leave Not receiving an education Excluded without provision Unlawful removal from roll Other Missing - whereabouts unknown Do you have written confirmation from the parents of the move within the UK? Yes No Upload written confirmation of move within the UK (optional) Family move date within the UK (if known) (optional) Do you have written confirmation from the parents of the move outside the UK? Yes No Upload written confirmation of move outside the UK (optional) Family move date from the UK (if known) (optional) Please give further details (optional) Date family moved to area? (if known) (optional) Please give further details (optional) Do you have written confirmation from the parents of the move? Yes No Upload confirmation of the family move (optional) Date family moved (if known) (optional) Have enquiries been made with the parent(s)? Yes No Don't know Details of enquires made with parents Have enquiries been made with friends/family/teachers? Yes No Don't know Details of enquiries been made with friends/family/teachers Have enquiries been made with professionals - eg social worker? Yes No Don't know Details of enquiries been made with professionals Has a home visit been carried out? Yes No Don't know Date home visit was carried out (if known) (optional) Home visit outcome (optional) -- Please Select -- The property is empty of furniture New residents confirmed the pupil's family have left New residents do not know the pupil's family A neighbour confirmed the family has left The landlord confirmed the pupil's family have left No answer but the property appears lived in Contact made with parent/family at the visit Further details of home visit (optional) Is there involvement from Children Social Care? Yes No Don't know Further details of involvement from Childrens' Social Care (optional) Is there involvement from the Youth Offending Team? Yes No Don't know Further details of involvement from the Youth Offending Team? (optional) Are there any risks we need to be aware of in carrying out a home visit? Yes No Don't know Further details of any risks we need to be aware of in carrying out a home visit (optional) Is there anything else that might assist with our enquiries? Please remember to include any information regarding risks such as Domestic Violence, FGM, Radicaisation, Forced Marrage, any missing from home episodes etc. (optional) No information is required, please proceed to the next page. Page 6 Referrer's details Referrer type -- Please Select -- School Other agency Member of public First name Last name Designation Organisation name LCC school number (optional) Relationship Telephone number Email address No information is required, please proceed to the next page. Before you submit this form please review your answers below. If you need to change anything, use the 'previous' button on the bottom left to go back to a section. Then submit the form by selecting the 'Submit button' at the bottom of this page Loading form summary...