London Apprenticeship Project Referral Form

Aims of the Project

Disability Rights UK is a Pan-Disability organisation aiming to support young disabled adults interested in pursuing their career goals irrespective of their learning difficulty, disability or health condition. The project aims to tackle key barriers hindering access to apprenticeships for disabled people.

Eligibility Criteria

To access the support of the London Apprenticeship Project individuals must:

Be aged 16-24 and have a disability, impairment, learning difficulty or health condition as defined by the Equality Act 2010

Be a resident of an inner London borough (Camden, Greenwich, Hackney, Hammersmith and Fulham, Islington, Kensington and Chelsea, Lambeth, Lewisham, Southwark, Tower Hamlets, Wandsworth and/or Westminster)

Have an interest in accessing an apprenticeship, work towards one or currently be undertaking one and benefit from additional support

Completing the Form

Please provide as much information as possible for each section. In order for a referral to be processed promptly, you must indicate whether the individual has been made aware of the referral being made and its purpose. Where possible, individual consent must be acknowledge by a person’s signature or confirm whether that person agrees to being contacted by DRUK.

Prospective Clients

If your referral meets the project’s eligibility criteria, we will aim to be in contact within 7 working days to arrange an individual discussion of skills, aspirations and support needs. If you would like to discuss the referral, have any questions about any part of the process or require help to complete this form then please contact Danny Estrada on 020 7566 0118.

Please make referrals for the attention of Danny Estrada and send to: or via post to: Disability Rights UK, Apprenticeship Project, 12 City Forum, 250 City Road, London, EC1V 8AF

London Apprenticeship Project Referral Form

Forename/s: / Surname: / For office use

Date Received:
______
Referred by
______
Date of individual discussion of skills, aspirations and support needs
______at______
Attended:
Yes
No / Cancelled
2nd Appointment: (Date/time)
______at______
Attended:
Yes

No / Cancelled
Sign Posted:

Yes

No
To: ______
Date: ______
Service not provided: (SNP)
Yes
Date:______
Reason: ______
Home Address:
Home Postcode: / Borough:
Is this your permanent resident address?

Yes No
Date of Birth:
Gender:
Male Female
Telephone No: / Email:
Please provide any relevant information that will help us process this referral
Do you have any special requirements for attending a discussion of skills, aspirations and support needs?
Yes No
If yes, please give details
Referrer’s Details:
Telephone: / Email:
DRUK are committed to confidentiality. As such this referral cannot be processed without the individual’s consent. Where a signature cannot be provided, please indicate whether individual has given expressed consent.
Client’s Signature: / Date: