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*

Course Applied for at Barnsley College*

Your school

Name of Secondary School*

When did you/When will you leave?*

Have you previously studied at Barnsley College?*

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*

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

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.

Additional Learning Support Questionnaire (ALS2)

To be completed by the learner:

Your school

How we can best support you

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