Children Missing Education Referral Form
Pupils Information
Action Taken by School
Confirmation
Receipt
School must maintain ownership of the pupil's records until advised by the Local Authority Pupil Tracking
Officer to remove from roll.
School must create a Common Transfer File (CTF) and post this electronically on the missing pupil database
(S2S) when removed from roll.
Removal from roll must comply to DfE and LA procedures.
Pupils Information
To be completed for pupils who have gone 'missing' or where forwarding school or address is not known.
Name of Pupil:
Date of Birth (dd/mm/yyyy):
Name of School:
Year Group:
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Ethnicity:
English, Welsh, Scottish, Northern Irish or British
Irish
Gypsy or Irish Traveller
Any other White background
White and Black Caribbean
White and Black African
White and Asian
Any other Mixed or Multiple ethnic background
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
African
Caribbean
Any other Black, African or Caribbean background
Arab
Any other ethnic group
I wish not to disclose
UPN:
Gender:
Male
Female
Other
SEN Status:
EHCP
In School Support
None
Names of Parents/Carers of Missing Pupil
Parent/Carer Title:
Mr
Mrs
Miss
Ms
Sir
Rev
Dr
Forename:
Surname:
Second Parent/Carer Title:
Mr
Mrs
Miss
Ms
Sir
Rev
Dr
Forename:
Surname:
First Parent/Carer's Details
Postcode Search
Property Name / Number
Street
Area
Town
County
Postcode
Telephone Number:
Email Address:
Family/School Information
Area Family May Have Moved to:
Name of Sibling:
Date of Birth (dd/mm/yyyy):
Name of School:
