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Additional Learning Support Questionnaire (ALS2)
To be completed by the learner:
Name
*
First
Last
Your email address
*
This will be used to send a copy of your submission to, so please use an email address that you access regularly.
Date of Birth
*
Date Format: DD slash MM slash YYYY
Course Applied for at Barnsley College
*
Your school
Name of Secondary School
*
When did you/When will you leave?
*
Date Format: DD slash MM slash YYYY
Have you previously studied at Barnsley College?
*
Please select
Yes
No
Student Number
When did you study with us?
*
If you don't know the exact date, you can give a rough estimate
DD
MM
YYYY
How we can best support you
Nature of your disability/difficulty
*
Dyslexia
Dyspraxia
Asperger’s
Autism
Moderate Learning Difficulties
ADHD/ADD
Hearing Impairment
Visual Impairment
Physical impairment
Mobility Impairment/ wheelchair user
Behaviour
Mental Health
Medical
Other
None
Please specify
Do you have an Educational Health and Care Plan?
Yes
No
EHCP issued by which local authority?
Please tell us about your difficulties and how we can support you at College:
Previous Support
*
Please tell us about the support you have had in the past:
In class support
Small group out of class
1:1 out of class
Note taker
Communicator/signer
Specialist software
Hearing Loop
Coloured overlays
Other
Please specify
Did you have special arrangements in any exams?
*
Yes
No
Please tick below
Extra Time
Reader
Scribe
Rest Breaks
Use of laptop
Modified paper
Separate room
Braille/enlarged text
Prompt
Other
Please specify
Any information disclosed will be treated confidentially. However, in order to provide the best support for you this information may need to be shared with other people within the college e.g. course tutors, exams department.
Consent
*
By ticking this box I give permission for information concerning my support needs to be shared with relevant departments.
Last updated: 28th May 2020
In this section
Additional Learning Support – Information for apprentices and work-based students
Additional Learning Support Questionnaire (ALS2)
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Conditions
Dyslexia, Dyscalculia, Dysgraphia and Dyspraxia
Exam Access Arrangements
Hearing Impairment
Mental Health Conditions
Physical Disability
Specific Conditions/ Disabilities
Visual Impairment