An independent specialist setting
for students with autism and anxiety
01905 349915

Parental Initial Enquiry Form

Potential students will only be offered a place at a Wider Ambition setting if they meet the following criteria:

  • Have a diagnosis of autism or present with characteristics consistent with autism, or present with Social, Emotional or Mental Health (SEMH) needs such as anxiety, sensory needs or low mood which may be co-morbid with autism.
  • Have the academic ability to follow an age-appropriate curriculum in the format offered at the setting and achieve at average or above-average levels.
  • Are unlikely to display behaviour at the setting which would impact on other students or themselves.
  • Are considered, at our sole discretion, to be someone who would benefit from attending the setting and for whose profile of needs the physical environment, social context, and embedded therapeutic offer are appropriate.
  • Are considered, at our sole discretion, to be someone whose attendance would not cause unreasonable detriment to existing students.
  • Are, or are expected to be, eligible for Local Authority funding via an Education, Health and Care Plan or can provide evidence of other means of funding a placement.

By submitting this form, you confirm that you believe that your child fulfils the above criteria.

Preferred means of contact

If Wider Ambition receives a consultation from a local authority about the above young person, are you happy for us to respond to this?

Where more than one person has parental responsibility, they should both provide consent where possible.

By submitting this form, you agree to the following:

I accept the Admissions Policy and the Data Protection Policy for Lokrum Fields, which I can access on the policies page of this site.

I give consent for personal information relating to me or to the above potential pupil to be processed accordingly.

I understand that if I do not want any personal information to be shared with the third parties listed in the Admissions Policy, I must notify Lokrum Fields in writing at the earliest opportunity.

If my child is over 13 years old, they have given their consent for me to include their personal data in this form.

You can download this form here.