Galvin’s Chance – Application Form
Introduction
Galvin’s Chance is a programme to support young people aged 18-24 into work in the hospitality sector. The jobs are working in Front of House roles working in high-end hotels and restaurants across London. Galvin’s Chance is a partnership between DM Thomas Foundation for Young People, which oversees the programme and funds the placements and The Springboard Charity, which delivers the training and mentoring.
Once selected on to the Galvin’s Chance Programme, chosen candidates will complete training and two weeks work experience with a view to fulfilling a vacancy. We actively encourage participants to enrol on accredited courses such as the NVQ Hospitality Apprenticeship (Level 2) to further their learning and enhance their careers.
Referral form
This form is to be used in the referral of all Galvin’s Chance candidates. All referrers need to fill in part A, and ensure the applicant signs the declaration on the final page. For those referring applicants with an offending background please also complete part B.
It is helpful for the programme recruitment processes if the referrer can help brief the candidate on the core purpose of the programme – for the young person to secure training and work in the hospitality sector (hotels and restaurants). There is more information about the programme and success story examples at www.galvinschance.co.uk.
Part A
1. PERSONAL DETAILS OF APPLICANT
Family name: / Forenames:Date of Birth (dd/mm/yy)
Age
Candidates should be aged 18-24 at the point of enrolment / Male/Female (please circle)
Address / Contact Phone Numbers
2. REFERRER DETAILS
Job Title:
Organisation:
Contact Numbers: / Email:
Signed: / Date:
Please complete sections 3, 4, 5 and 6 with young person
3. Reason for Referral (Please say why you want to do the programme)
4. Here are some examples of the skills and experience required for the programme. Please tell us how you have met these (this could be from work, social, family).
5. Does the candidate have prior experience of the hospitality sector (e.g. waiting, kitchens, customer services)?
6. Other agency involvement (Please give details of who else had or is in contact with the applicant)
/ Name & contact of Worker / Length of time worked / Comments and work already carried out /Connexions
Child & Adolescent
Mental Health
Education Services
e.g. educational psychology/welfare/ learning mentor
Health
JCP
Housing
Social Services
Mentor/other support
Voluntary Sector / other- please name?
Youth Service
Probation/YOT Team
Other – please advise
Please provide any further information on the above that you think is relevant
Declaration
I understand that the information on this form will be used by the Galvin’s Chance programme partners and The Springboard Charity to help plan, deliver, fundraise, monitor and evaluate their work. I confirm that I give my consent and understand my right to ask to see the information held about me by the Galvin’s Chance programme partners and The Springboard Charity.
Signed:
Print Name:
Date:
Referrers Signature:
Date:
If you are referring from YOT or Probation or working with a young person who has an offending background, please ensure part B is completed
Please note – If you have Risk Assessment for this client please send a copy with their referral form.
Part B
Self Declaration Form
The Working with Offenders Policy and Guidance must be read before using this form. It gives advice on how to complete it and contains the list of offences which identify the need for a risk assessment.
This form is for young people identified through Galvin’s Chance programme partners as offenders currently under the supervision of a criminal justice agency / in custody / subject to any other sentence, or who in the last 12 months have had a formal reprimand / final warning or finished: a period of supervision, custody, or any other sentence.
It must be used by Springboard staff or referral agency staff working with the young person. If delivery partners do not have a process of assessing the needs of young offenders, this form can be shared and used as a template to create their own.
If the candidate is being referred from an agency Prison on discharge
(please tick) YOT
Probation
Other (please specify) ______
2. PERSONAL DETAILS OF CANDIDATE
Family name (including any aliases): / Forenames (including any aliases):Date of Birth (dd/mm/yy) / Male/Female (please circle)
PNC: / Prison No: / Contact Phone Numbers
Address
Expected release date if currently in custody (dd/mm/yy) (Please also indicate
potential early release date) / Will the candidate be on a Tagging Order?
Home Detention Curfew? / YES/NO
YES/NO
Living Arrangements
Does the candidate have any history of the following offences?
Schedule 15 offences found on Trustnet/Strategy & Policy/ Young People
Schedule 1 offences listed in Appendix 1 of the Working with Offenders Guidance. / (a) Sexual Offences (listed in Schedule 15 of Criminal Justice Act 2003)
(b) Violent Offences (listed in Schedule 15 of Criminal Justice Act 2003) / YES/NO
YES/NO
(c) Is the person identified as
presenting a risk, or potential risk, to children (offences listed in Schedule 1 of Children and Young People’s Act) / YES/NO
(d) Arson / YES/NO
3. SUPERVISING OFFENDER MANAGER/YOT OFFICER DETAILS
Name / Work Address:Job Title:
Contact Numbers:
4. LIAISON DETAILS [the person making the referral if different from above]
Name / Work Address:Job Title:
Contact Numbers:
Signed: / Date:
5. Explanation and details of offence
Please give further details on offending background, criminal history and any time spent in prison and provide as much information with possible, etc. Please provide a disclosure form with this application form.
REFERRALS
à If referring the young person please send this form to The Springboard Charity, Galvin’s Chance; member of staff () for the attention of Ruth or fax on 0207 387 1184. If there are any offences that trigger a need for risk assessment, please be aware The Springboard Charity staff may need to share this information and seek advice from line management.
à If this is a referral from a prison, agreement will be obtained from the appropriate Offender Manager/YOT Officer for the candidate to attend the Programme.
Section 5 must be completed at the meeting between the candidate and the Galvin’s Chance Programme Manager.
5. CANDIDATE DECLARATION
I have read (or heard) the information given about me on this form.I understand that this information is needed by Galvin’s Chance programme partners, The Springboard Charity, and other organisations directly involved on their behalf, to help plan, deliver, monitor and evaluate Galvin’s Chance Programmes
I confirm that I give my consent to The Springboard Charity to collect and store the information disclosed to be used for statistical and fundraising purposes. I understand my right to request a copy of the information held about me by The Springboard Charity.
· I agree that the information provided in my assessments may be shared with other agencies working with The Springboard Charity who can contribute to my care whilst on the Galvin’s Chance Programme, and any agencies acting on behalf of these organisations.
· I understand that this information will be used for the purpose of providing a service, or care to me and may result in further risk assessments before I can be accepted onto the programme.
· I also understand that agencies may use this information for statistical purposes and that the law may allow in some circumstances for other agencies to be provided with information about me.
· I understand that I may withdraw my consent to share information at any time and this may result in a reduction of services being available.
· I understand that my information will be held securely on paper and on computer in accordance with the Data Protection Act 1998.
· I have made the following restrictions: (if applicable)
Signed ______Date ______
Member of The Springboard Charity staff on behalf of Galvin’s Chance:
Full name:
Title:
Received/logged Signed Date
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