Notification of removal from roll (form 11)

This form is used to inform the Local Authority that a student has been removed from your school roll. The destination of that child is known and the appropriate tracking of this child has been completed. This includes children moving out of the Country – proof of travel has been seen and an address has been obtained. This is in line with CME Guidelines 2016

Please also be aware that this does not replace safeguarding procedures. Should you have concerns about a child then you must report these to the first contact team professionals line immediately on 01332 641172 and also the police on 101.


The fields marked with an asterisk (*) are required fields. All the information you enter will be submitted securely.

Referrer's details

* School name
* Your name
* Your email address
* Confirm Your email address

Pupil details

* Full name
* Date of birth
* UPN
* Are there any siblings in your school who have also left?
* Regulation removed from roll
* Date removed from roll
* Has child moved schools within Derby city?

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