3.1 Has the applicant's potential to participate fully in extra-curricular activities been constrained as a result of their disability/condition?
Yes ○ No ○
3.2 Has the applicant received support due to the emotional impact of the disability/condition from any of the following? (you may select more than one) Yes
No 〇
If yes, a specific example is required:
Guidance Counsellor
Chaplain
Psychotherapist
Child and Adolescent Mental Health Services
Psychologist
Other, please specify:
3.3 Has the disability impacted on the applicant's time, either
a)it takes them a considerably long time to complete school work/study or
b)they have reduced time for school work/study due to managing their condition?
Yes ○ No ○
If yes, describe how the applicant's disability/condition causes these time-related challenges:
Yes ○ No ○
Indicator 4: Learning and Exam Results
4.1 If the applicant acquired the condition when in your school (or their condition deteriorated), have their grades significantly decreased since onset/deterioration?
No 〇
Not Applicable
If yes, please pick three subjects and use in-house (school) exams, pre and post onset/deterioration, to show this. It is recommended you use Maths, English and another subject: