Section D: School Statement 2027
This form, to be completed by the applicant's school, is ONLY for applicants applying under the Dyslexia (Significant Literacy Difficulties) category, who do not have a full Psychological Assessment Report identifying Dyslexia.
Please complete all sections below in TYPE or BLOCK capitals:
1. Applicant details
Full Name of Applicant
Date of Birth
CAO Number
2. School details
| School details | |
| School Name |  |
|---|---|
| School Address | |
| Roll Number | |
3. Statement
We the undersigned declare that there is a current Student Support File in place which confirms that the applicant has a record of school-based interventions addressing persistent literacy difficulties.
We the undersigned agree that, to the best of our knowledge, all the information provided on this form is true, correct and complete.
| Signature of Applicant | Signature of Parent/Guardian (if applicant is under the age of 18 on 1 February 2027). |
|---|---|
| Print name of Special Educational Needs (SEN) Teacher | School stamp |
| Signature of Special Educational Needs (SEN) Teacher | |
| Print name of Principal/Deputy Principal | |
| Signature of Principal/Deputy Principal | Date:  |
Signature of Principal/Deputy Principal