Liverpool City Council

Details of responsible parent or guardian

Parent / guardian name:

Relationship to pupil:

Address:

Postcode

Use the Lookup Postcode button to find the address.

If you cannot find the address, please enter it manually

Contact number:

Has the parent formally agreed to the reduced timetable?

Yes
No

Details of school the pupil attends

School name:

School type:

Primary School
Secondary School
Special School

DfE number:

School provision:

School contact name:

School contact telephone number:

School contact email address:

Confirm school email address:

Details and duration of reduced timetable

Reason for the reduced timetable:

Start date of reduced timetable: dd/mm/yyyy

End date of reduced timetable: dd/mm/yyyy

Total days on reduced timetable:

The number of weeks the pupil will be on a reduced timetable: Pupils cannot be on a RTT for more than 8 weeks unless the RTT case has been reviewed by the Local Authority Children Out of Provision Panel and deemed as an exception

Number of hours of educational provision offered per week to the pupil:

Start date of Alternative Provision, if applicable: - optional dd/mm/yyyy

Reduced Timetable agreed by SEN team: (if applicable)

Yes
No
N/A

Name of SEN Caseworker:

Review date: dd/mm/yyyy

Any additional comments: - optional

Upload the completed checklist for reduced timetables: - optional

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

Reduced timetable Notification for schools