Children’s Services
EMTAS
Referral Form English as an additional language (EAL) / Gypsy Roma Traveller (GRT)
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Date of Referral:
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Pupil’s Name:
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D.O.B:
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Country of birth:
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Have the parents been informed of the referral?
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Pupil’s Address:
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Name and Address of School:
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Name of Head Teacher:
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Name of EAL Co-Ord/Inclusion Manager:
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Name of Referrer:
Gender:
School year:
Attendance (GRT):
%
Other relevant Agencies involved if applicable (including named contact person/s):
P.T.O…….
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Language spoken:
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Religion:
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Pupil’s first/home language:
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Is the pupil a New Arrival to your school/ the U.K:
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Has the pupil any previous learning:
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Can the pupil read in first language:
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Can the pupil write in first language:
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GRT Pupils Only
NC Levels Maths:
NC Levels English:
Reading age:
Spelling age:
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Any medical need:
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Reason for referral:
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Any other relevant information:
Office Use Only
Pupil allocated to:_______________________________________(EMTAS TA / Teacher)
Date: __________________
Approved by line manager:___________________
Please return the completed form to: EMTAS@salford.gov.uk