Weldbank Lane, Chorley, Lancashire, PR7 3NQ
01257 249803

Referral Forms

(OCT 2023 update- forms have been updated - please ensure you submit the correct version to avoid delays)

Key Stage 3 Intervention

Please click the image to download this form - complete it is full to avoid delays and return it  to admissions@shaftesbury.lancs.sch.uk

 

 

Key Stage 4 Intervention

Please click the image to download this form - complete it is full to avoid delays and return it  to admissions@shaftesbury.lancs.sch.uk

Key Stage 3 or 4 Medical Place Request

  1. Please click the image to download this form to send it to the consultant to complete it in full if you are requesting a Medical Place.   Alternatively you could forward a link to this page so that they may download it themselves. 

  2. School must also complete one of the above green or blue forms.

  3. When both forms are complete please email them and any supporting evidence directly to SSS Medical central mailbox here 
  4. Submission must be by 12 noon the day before the published panel dates - link to dates

 

 

 OR

 

 

 

 

 

 

 

 
 
 
Weldbank Lane, Chorley, Lancashire, PR7 3NQ
01257 249803

Referral Forms

(OCT 2023 update- forms have been updated - please ensure you submit the correct version to avoid delays)

Key Stage 3 Intervention

Please click the image to download this form - complete it is full to avoid delays and return it  to admissions@shaftesbury.lancs.sch.uk

 

 

Key Stage 4 Intervention

Please click the image to download this form - complete it is full to avoid delays and return it  to admissions@shaftesbury.lancs.sch.uk

Key Stage 3 or 4 Medical Place Request

  1. Please click the image to download this form to send it to the consultant to complete it in full if you are requesting a Medical Place.   Alternatively you could forward a link to this page so that they may download it themselves. 

  2. School must also complete one of the above green or blue forms.

  3. When both forms are complete please email them and any supporting evidence directly to SSS Medical central mailbox here 
  4. Submission must be by 12 noon the day before the published panel dates - link to dates

 

 

 OR