Child's details Child's full name Child's date of birth School that your child has been permanently excluded from Date on the school governors meeting letter you received about your child's permanent exclusion Next Page Parent or carer details Parents can request a joint review. If you live at different addresses, we'll only send papers to the address given below. Your full name Email Phone Address Your relationship to the child Previous PageNext Page People at the hearing Do you want to attend the hearing? YesNo Please give any dates that you're not available within the next 15 school days Do you want a Special Educational Needs (SEN) expert at the hearing? YesNo Do you want a county council representative to attend, if your child has been excluded from an academy? YesNoNot applicable Do you want your child to attend the hearing? YesNo Do you want to be represented at the hearing? YesNo Previous PageNext Page Your representative's details Name of representative Email of representative Phone number of representative Address of representative Previous PageNext Page Witnesses Do you want to bring a witness or witnesses to the hearing? YesNo Previous PageNext Page Your witnesses' details Name of witness(es) Occupation of witness Briefly, what sort of evidence will the witness(es) provide? Previous PageNext Page Special Educational Needs and Disabilities Do you believe your child has special educational needs? YesNo Previous PageNext Page Please give details of your child's special educational needs. If your child has a Statement of SEN or an Education, Health & Care Plan, please give details If your child is undergoing any statutory assessment process, please give details Previous PageNext Page What you need at the hearing At the hearing, do you need... disabled accessinterpreterBritish Sign Language interpreterhearing loop Any religious holidays to avoid? Previous PageNext Page Languages If you need an interpreter, what language do you speak? Which language do you speak? BengaliCantoneseItalianMandarinPolishPunjabiTurkishUrduOther If other, tell us which language you speak. Previous PageNext Page Reasons for applying for an independent review Let us know why you want a review Attach any supporting documentation (optional) - doc, docx, pdf, jpg, jpeg, png, gif doc,docx,pdf,jpg,jpeg,png,gif Previous PageNext Page Confirm and send We'll only discuss this request for an exclusion review with the person submitting the request. Tick to confirm you've read our guidance I've read and understood Hertfordshire County Council's exclusion review guidance. Tick to confirm parental responsibility I have parental responsibility for the child and the information given is true to the best of my knowledge. Previous Page SEND