Darlington SEND Information, Advice and Support Service
Supporting families of disabled children and children with Special Educational Needs

Independent Parental Supporter	

Application Form

Personal Details		

Surname:		

First Name:		

Address:		

		
		
Telephone Numbers		

Work:		

Home:		

Mobile:		

		
Please note the following in relation to being an Independent Parental Support with the Darlington Information, Advice and Support Service:	
	
This is a voluntary activity and not paid employment. Volunteers will be reimbursed for out of pocket expenses.	
	
Independent Parental Supports are not employees of Darlington Borough Council.	

Please return to:
Darlington Information, Advice and Support Service
North Lodge, Gladstone Street, Darlington, DL3 6JX
01325 405878
iass@darlington.gov.uk 

Employment or Voluntary Experience

Please tell us about any of your employment of voluntary experience that you think would be relevant to this role: 

References

Please give the names, addresses and telephone numbers of two referees who will be able to comment on your suitability for this role:

Special Needs

Please tell us about:

(a)	any reasonable adjustment you need to help you with your application

(b)   any reasonable adjustment you would need to help you carry out this role

Transport

Do you hold a full UK driving licence for a car?

Do you have a car?

Rehabilitation of Offenders Act 1974

This role is exempt from the provisions of the Rehabilitation of Offenders Act. 
You must give details of any convictions; both spent and unspent, on a 
separate sheet.

Reasons for applying to become an Independent Parental 
Support

Please tell us why you are applying for this role and why you think you are 
suitable candidate:

Signature:						Date:

Please return this form to:	Darlington Information, Advice and Support Service
North Lodge, Gladstone Street, Darlington, DL3 6JX
iass@darlington.gov.uk  

As part of this application please complete the following:

Say a bit more about what particularly attracted you to becoming an Independent Parental Support and what do you hope to gain from the experience:

Give examples of your previous work/life experience where you have used some or all of the skills and abilities listed in the person specification:

Sometimes parents of children with Special Educational Needs become very angry and frustrated. What would be the range of strategies you would use to deal with this?

What are the aspects of the role that you might find the most challenging and where you might need the most support?

Name:                                                                        Date:

What an Independent Parental Support does not do!

It is possible when working with a family that they may ask you to do things that are outside your role as an IPS. It is important however that parents do not become overly-dependent on their IPS, but are helped to make their own decision and to keep control of their child’s educational future.

As well as being clear about what an IPS is then, it is also important to know what it is not. The following are meant as guidelines:

An ISP should not:

•	Make professional judgements about what is best for a child

•	Give advice about what parents should do

•	Work with professionals involved with a child instead of the parents

•	Do things for parents which, with support, they could do themselves

•	Become a family counsellor

•	Become involved in issues other than the assessment and provision for the child’s special educational needs

•	Manage difficult situations without help

•	Baby-sit, do shopping or other errands

•	Be an advocate

Equal Opportunities Monitoring Form

To help us check that our recruitment procedures give genuine equality of opportunity, please answer the questions below and return this sheet with your application form.

Name:                                                         Age:

Do you consider yourself to be disabled?

Please tick box:           Yes                         No

If yes, do you consider yourself to be disabled under the terms of the Disability Discrimination Act?

The Disability Discrimination Act 1995 defines disability as a physical or mental impairment which has a substantial and long-term adverse affect on an individual’s ability to carry out normal day-to-day activities.

Please tick box:           Yes                         No

If you answered yes to either of the above questions, please complete the disability Statement attached. 

Gender

Please tick box:           Male                        Female

Ethnic Origin

WHITE

British                                                         Irish

Any other white background (please specify)

MULTI-ETHNIC

Black Caribbean and White                        Black African and White

Any other multi-ethnic background (please specify)

ASIAN OR ASIAN BRITISH

Indian                                                          Pakistani

Bangladeshi 

Any other Asian background (please specify)

BLACK OR BLACK BRITISH

Caribbean                                                   African

Any other black background (please specify)

CHINESE OR OTHER ETHNIC GROUP

Chinese

Any other ethnic background (please specify)

Disability Statement

Darlington Information, Advice and Support Service is committed to equality of opportunity for disabled people. Applications from disabled people are welcome. In order to help us fulfil our aims, please answer the following questions.

Is there anything you would particularly like to tell us about your disability?

If you wish us to try and arrange for any of the following to be available for you to attend the training, please tick. 

         induction look or other                                sign language interpreter
         hearing enhancement                                 (please state type)

         keyboard                                                     information transcribed on tape

         wheelchair access                                      accessible car parking

         accessible toilet                                          other assistance
                                                                            (please specify)

Signed:                                                                Date:

Name:

Thank you for providing this information. Please return this form with your application.