Client Referral Form
Note: This referral will prompt an email to the client. If it is not safe to email the client please do not complete this form and contact referral@workingchance.org instead to arrange an alternative.
Service Entry Requirements
ELIGIBILITY
:
Must be 18 years or older and identify as a woman or non-binary.
Has a criminal record, such as a conviction, caution, or out-of-court disposal.
Eligible to work in the UK (with supporting documentation, including in-date photo ID).
ENGAGEMENT:
Can independently engage with the service and has basic literacy and IT skills (formal qualifications are not required).
Has regular private access to the internet, a personal email address, a phone, a phone, and a computer or similar device for job applications.
Able to commit and consistently attend scheduled weekly video call sessions (scheduled Monday to Friday 9am-6pm).
Are service entry requirements met?
Please select...
I believe she/they meets the specified service entry requirements.
She/they may not yet meet all the entry requirements but would benefit from a call.
Should you have any questions, please contact Working Chance at the following email address: referral@workingchance.org
Referrer Details
Organisation Name
Location
Include borough where applicable
Contact Name
Contact Email
Client Details
First Name
Last Name
Mobile Number
Email Address
Is it safe to leave a voicemail?
Please select...
Yes
No
Don't know
Is it safe to leave a text message?
Please select...
Yes
No
Don't know
Is it safe to send an email?
Please select...
Yes
No
Don't know
Type of Support
We offer both Employment and Education & Training Support.
What sort of support are they interested in?
Please select...
Employment only
Education & Training only
Both, with a focus on employment
Both, with a focus on education & training
Consent
Please tick here to confirm that the client has authorised you to submit this referral on their behalf and that they are happy for you to share their data with Working Chance.
Once the referral is received, we'll ask the client to consent to our Privacy Policy before we proceed.
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Contact Information