Little Voices Supplementary Information Form Supplementary InformationAll information that is requested is the same information that is requested by the Examination Boards when we enter candidates for their examinations.Details Of Person Submitting Supporting InformationFull Name* First Last Relationship To Child*Little Voices Venue Where Initial Application Is Requested*Child's DetailsChild's Name* First Last Gender*Age* If child is 16 years or over please send supporting documentation for Learner Authenticity: copy of Birth Certificate and/or Photo ID eg Passport. Date Of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Examinations TakenChild’s Exam details: Please give full details of all Examinations Taken, Name of the Examination Board, Grade Taken, result if known and anything else we need to know.*Further Medical Condition InformationIf None state noneChild’s Circumstances: (please give full details)*Condition:* Permanent Temporary Please give details of applicant’s ability in the followingReading*Speech*Movement*Understanding Of Instructions*Memory (eg. memorising words of a script or song)*Concentration*Ability to focus*Aural skills*Interaction with others*Would reasonable adjustments need to be requested in lessons* Yes No If yes please give full detailsSupporting documentation attached with this applicationPlease choose the appropriate documentation For candidates 16 years and overPassportDriving LicenceBank Card or NI CardSupporting documentation attached with this applicationPlease choose the appropriate documentation For :Visual Impairment Qualified Optometrist DeclarationSigned Medical Practitioner ReportSupporting documentation attached with this applicationPlease choose the appropriate documentation For Medical or Physical Disability Signed Medical Practitioner ReportSupporting documentation attached with this applicationPlease choose the appropriate documentation For Physiological, Neurological, other Learning Difficulties Learning Statement from: A fully qualified and Chartered Educational Psychologist,Individual who holds a Special Needs Teacher Qualification,Schools Special Needs Coordinator (SENCO) or similar who holds an educational psychologist or special needs teacher qualification This form must be fully completed. Please do not submit this form to Little Voices without enclosing the appropriate supporting documentation to your principal. We ask for this documentation because Little Voices teaches to examinations and assessments which are subject to the requirements of examining bodies, which themselves require the provision of appropriate supporting documentation in any application for Reasonable Adjustments or Special Consideration. Applicant DeclarationI the above named person submitting this form confirm that the information contained in this form is accurate. I understand that the information I have provided will be used when Little Voices has a group lesson to offer the child named above. If the application is successful the information will be used to consider reasonable adjustments that will need to be applied.Electronic Signiture*Full Name Printed* First Last Date Signed*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920As an organisation Little Voices have a duty to ensure the integrity of the lessons is maintained at all times and assessment in the form of examinations. At the same time we have a duty to ensure the rights of every individual child and young person to access Little Voices lessons and assessments in the most appropriate way for their needs. Little Voices must comply with LAMDA Code of Practice to enable it to be a registered examination organisation. Little Voices aims to facilitate open access to all its lessons for children and young persons who are eligible for reasonable adjustments in lessons, without compromising the teaching, learning outcomes and assessments (required by the examination boards) of the skills, knowledge and understanding or competence being measured and taught.
For candidates 16 years and over
For :Visual Impairment
For Medical or Physical Disability
For Physiological, Neurological, other Learning Difficulties Learning Statement from:
Little Voices must comply with LAMDA Code of Practice to enable it to be a registered examination organisation. Little Voices aims to facilitate open access to all its lessons for children and young persons who are eligible for reasonable adjustments in lessons, without compromising the teaching, learning outcomes and assessments (required by the examination boards) of the skills, knowledge and understanding or competence being measured and taught.