ELECTIVE HOME EDUCATION (EHE) NOTIFICATION

FORM

Notification of intent to home educate your child.

This referral form is for notifying the Local Authority of your decision to home
educate your child/ren. It should be completed with as much detail as possible for
any child between the ages of 5 and 16 who has been withdrawn from school or
never been registered at a school and is being educated at home by parents /
carers.

Please complete and return this form by email to:

[email protected]

PARENT / CARER DETAILS

NAME OF PARENT / CARER:

ADDRESS:

EMAIL ADDRESS:

TELEPHONE NO:

CHILD’S DETAILS

CHILD’S FIRST NAME:

SURNAME:

ALTERNATIVE NAME: SCHOOL YEAR:

DOB: GENDER:
ETHNICITY:

CHILD’S ADDRESS:

POST CODE:
PARENT/CARER NAME: PARENT/CARER NAME:

RELATIONSHIP TO CHILD: RELATIONSHIP TO CHILD:

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ELECTIVE HOME EDUCATION NOTIFICATION FORM SEPTEMBER 2024
PARENT / CARER RESPONSIBILITY: PARENT / CARER RESPONSIBILITY:
YES: NO: YES: NO:

PARENT / CARER ADDRESS/CONTACT PARENT / CARER ADDRESS/CONTACT DETAILS

DETAILS (Where different )
(Where different )

POSTCODE:
POSTCODE:
HOME TEL NO: HOME TEL NO:

MOBILE PHONE: MOBILE PHONE:

EMAIL ADDRESS: EMAIL ADDRESS:

Is this child a sibling of a child currently registered for EHE YES NO UNKNOWN
Are you completing additional EHE referrals for other sibling/s YES NO
alongside this referral?
OTHER CHILDREN IN THE HOUSEHOLD (please list names, dates of birth, and if registered for EHE if known):
NAME DOB REGISTERED FOR EHE Y/N NAME OF SCHOOL

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DOES YOUR CHILD HAVE SPECIAL YES: NO:
EDUCATIONAL NEEDS AND/OR A
DISABILITY?
If yes, please tell us more.

DOES YOUR CHILD HAVE AN EDUCATION, YES: NO:

HEALTH AND CARE PLAN (EHCP)?

DATE OF EHC PLAN: DATE OF LAST REVIEW:

/ / / /

NAME OF CASE OFFICER

YES if yes please describe health needs below:

DOES THE CHILD HAVE ANY HEALTH
NEEDS?
NO

What reason has been given for the child being educated at home?

IS YOUR CHILD ON A CHILD PROTECTION YES: NO:

PLAN?

IS YOUR CHILD ON A CHILD IN NEED PLAN? YES: NO:

IS YOUR CHILD KNOWN TO THE YOUTH

YES: NO:
JUSTICE SERVICE

NO

CURRENT SCHOOL DETAILS

Has your child ever attended school? Yes: No:

1. Name of current school:-

2. Date of child’s last attendance
(dd/MM/YYYY)

3. Date roll removal (if applicable)

(dd/MM/YYYY)

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ELECTIVE HOME EDUCATION NOTIFICATION FORM SEPTEMBER 2024
Have you written to the school to notify Date sent:- (dd/MM/YYYY)
them of your intentions to home educate? Attached: Yes/No

Tell us about your child’s educational

journey so far.

Do you receive/ require any support to

ensure your child receives a suitable
education?

How does your child feel about being home

educated?

Please circle your reason for electing to home educate from the list below? (Please tick the most
appropriate)

Tick
Reason for EHE Explanation and examples
here
1 Physical Health Child is EHE due to one or more physical
health conditions e.g. autoimmune illness.
2 Mental Health Child is EHE due to one or more mental
health conditions e.g. anxiety.
3. Health concerns relating to Covid-19 Child is EHE due to underlying health
conditions which increase their, or a member
of their families, risk of serious illness from
COVID-19 or anxiety regarding COVID-19
transmission.
4. Did not get school preference Child is EHE as they did not receive their first
choice of school preference and their parents
were unhappy with any other option. This
should be used in cases where it was the
parent’s choice as opposed to there being no
school place available, in which case
‘Difficulty in accessing school place’ should
be used.
5. Permanent exclusion Child is EHE as they were permanently
excluded from their previous school and
parent did not want or get alternative
education arrangements (e.g. alternative
provision)
6. Risk of school exclusion Child is EHE as parents chose to remove the
child from school before the child was
excluded.
7. Difficulty in accessing a school place Child is EHE as there are no suitable school
places available e.g. for geographical
reasons such as moved home and no
suitable school with available places or

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ELECTIVE HOME EDUCATION NOTIFICATION FORM SEPTEMBER 2024
 difficulty in accessing a school that meets the
child's needs. This should be used in cases
where there is no school place available, as
opposed to the preferred choice not being
available.
8. Philosophical or preferential reason Child is EHE as the parent prefers to home
educate in order to follow child-centred,
flexible approaches to learning instead of
mainstream education, or parent feels their
child is more suited to home education.
9. Religious reasons Child is EHE as their religious views were
not compatible with the school ethos or
curriculum
e.g. in regard to relationships and sex
education.
10. Lifestyle choice Child is EHE due to their family’s lifestyle
choice. This could be as their family travels
regularly e.g. service children, Gypsy/Roma,
Traveller of Irish heritage, child actors, circus
performers etc.
11. Suggestion/pressure from school Child is EHE as they have been off-rolled by
the school e.g. to suggest home education
for a child who is not attending school
regularly, or behavioural needs are not being
met at the school.
12. General dissatisfaction with school - Child is EHE as they left their previous
general school due to general dissatisfaction e.g.
unhappy with the curriculum of the school,
ethos of the school, member of school staff
etc.
13. Dissatisfaction with school - SEND Child is EHE as they left their previous
school because their needs were not met or
there was inadequate SEND provision.
14. Dissatisfaction with the school - Child is EHE as they left their previous
bullying school because of bullying which was not
resolved.
15. No reasons given The reason why child is EHE was not
provided by parents or parents refused to
give a reason.
16. Other

17. Unknown
Additional Information – Please can you answer the questions below

1. What are you setting out to achieve through your home education?

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ELECTIVE HOME EDUCATION NOTIFICATION FORM SEPTEMBER 2024
2. Curriculum proposed e.g. subject/area, content, resource, delivered by parents / carers or
tutor

3. If you have a regular timetable please complete the weekly planner below.

MON TUES WED THUR FRI SAT SUN

4. If you do not have a fairly regular pattern, approximately how many hours are involved in
educational activities each week?

5. Methods to be used - teaching and learning strategies planned; and whether

arrangements are to be made for external examinations, if appropriate.

6. How will you know if your child is making progress? (for example, you might want to:
record work completed, take photographs, blog, video, keep a journal, mark work, identify
milestones reached).

7. What are your child’s thoughts & hopes about being home educated? (they might want to
include a drawing or some writing as age appropriate?)

8. What work have you been doing since you started home education?

9. Visits - arrangements made to give child experience of interest outside of the home to

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ELECTIVE HOME EDUCATION NOTIFICATION FORM SEPTEMBER 2024
 include the local/wider environment.

10. Social Contacts/Physical Activity - arrangements to be made for play, games, clubs,
societies or groups.

11. Agency contact - Either statutory or voluntary (e.g. Educational Welfare Officer, Education
Otherwise, etc.).

12. Any other information.

Are you familiar with the DfE Elective

Home Education guidance for YES NO
parents?

Parent / Carer signature Date

Thank you for filling in this form.

Please return the completed form to [email protected]

Elective Home Education Team

4th Floor Annexe,
Bernard Wetherill House,
8 Mint Walk,
Croydon, CRO 1EA

A member of the EHE team will be in contact shortly.

Please note: the form will be returned if it is submitted incomplete.

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