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ANNEX E SAMPLE STUDENT SUPPORT PLAN
What happens with this plan?
Stevenson College wants to ensure you get the personal support you need while you study at the college. By providing information for this plan you are helping the college to identify your personal support needs in order to arrange the support you need and familiarise you with any college equipment that can be provided for you. The information in this document may be passed on to other faculties within the college, to assist in this process.
Personal Details
Name :
Address:
Tel:
Emergency Contact:
Tel
Medical Information
I have diabetes
I have epilepsy
Chest/ heart condition
Other please state:
I am currently taking specialised medication and here are the details / how administered
If you currently supported with this medication, how are you supported in an emergency and is there a procedure which should be followed in college?
Course Details
Course :
Days and times of attendance in college
Days | Please state classes
and start times | Room/s for classes |
Monday | | |
Tuesday | | |
Wednesday | | |
Thursday | | |
Friday | | |
Saturday | | |
Personal Tutor:
Support around college
Mobility
Please tick if any of these aids are used:
Electric wheelchair/ manual wheelchair/ mobility aid/ stick
Travel to and from college
Stevenson College can provide you with support on arrival and departure from college. Please tick the boxes below to let us know if you require this support.
How do you travel to college?
I use public transport:
Completely independently
I may need support in bad weather
I use a private car:
Completely independently
I may need support on arrival
I may need support on departure
I will use Social Work Transport:
Completely independently
I may need help on arrival
I may need help on Departure
I walk to college
Moving about college
I move around college independently
I move around college with a guide dog/ cane
Personal Care
I do not need assistance with personal care
I am supported by a PA or Support Worker
I require to use a college hoist / stand-aid
Refectory
I am completely independent in the refectory
I am supported by a PA or Support Worker
Occasionally I may require support in refectory
Here are details of occasional support needed:
Health and Safety Information
This part of the agreement is completed for all students who will use the safe haven in the college and is to be used in conjunction with a health and safety talk.
Wheelchair user:
Yes Electric/manual
No
I confirm that I have received a copy of the emergency evacuation procedures.
I agree to wait in the safe haven and be evacuated from the building by a member of the fire brigade should this be necessary.
Declaration
This agreement is active from when I start college, but if I decide to make changes or would like the support detailed in this agreement to change at any point, I will inform the Access and Inclusion Co-ordinator at Stevenson College.
Student / Student Contact Signed
Access and Inclusion Co-ordinator Signed
Notes
Provision of Additional Educational Support
Educational Support provided by School -
Ambitions
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Educational Qualifications
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Educational support provided by school
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