Referral Form

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Your Journey
Opportunities
Join Programme
About
News

1Referral Source

2Personal Details

3About You

4Consent and Privacy

Before we start...

WE Work for Everyone engages and supports people with a learning difficulty, learning disability and autistic people to identify ways to move closer to the labour market.

Please make sure you meet all the WE Work eligibility criteria below:(Required)

I have a learning difficulty, learning disability or am autistic
I have the right to live and work in the UK
I live in either Bristol, Bath and North East Somerset or South Gloucestershire.
I am not in employment
I am 16 years or over
I aspire towards paid work

Yes - I meet all of the criteria above

Who is completing this form?

I am completing this form for myself

I am completing this form on behalf of someone else

What is your relationship to the participant?

I’m a parent / guardian / relative / friend

I’m a professional working with this person

Name of referrer

Referrer Phone Number

Referrer Email Address

Name of Organisation? (eg. Temple St Job Centre, BCC team, FE College)

Would you like to receive updates about the WE Work programme?

By ticking ‘yes’ I understand my email address will be added to the WE Work for Everyone mailing list.

Yes

Person being referred

Contact details

First Name

Surname

Address

Postcode

Phone Number

Email Address

Date of Birth

Day

Month

Year

Gender

Please tell us the best way to contact you? (tick all that apply)

Phone

Text

Letter

About You

Do you consider yourself to have any of the following? (tick all that apply)

Learning Disability

Learning Difficulty

Physical Disability

Autism Spectrum Condition

Mental Health Issues

Sight Impairment

Hearing Impairment

Other work limiting illness or condition

I do not have a disability

Please tell us anything you think would be useful for us to know about your disability or health needs.

Support services & work

Please tell us about any help or support you currently get?

Do you have a Social Worker?

If yes, please tell us their name and contact information:

Yes

Social Worker Name

Social Worker Telephone Number

Social Worker Email Address

What kind of job or training do you want to do in the future?

Please tell us what main benefit you receive?

Before we meet, is there anything else we should be aware of?

For example, how you prefer to communicate or any access needs?

Consent and Privacy

All information provided will be treated confidentially and in accordance with the General Data Protection Regulation (GDPR) and UK Data Protection Laws (UK GDPR & DPA 2018). It will be stored by the Council and used to compile anonymous statistics to inform the Council and its funding partners. Personal and sensitive information will be used solely for the purpose of equalities monitoring to ensure that everyone is treated fairly.
Please read our Privacy Notice and an accessible version Here .

My Consent(Required)

I have read the above Privacy Notice and consent to my information being used in this way

I give my consent to WE Work to contact referral organisations who can support my enrolment onto the programme e.g. Job Centre Plus, School/College, Social Work teams.

I also consent to sharing the following with WE Work, if they apply to me:

My EHCP (Education Health and Care Plan)

My Vocational Profile

Your name(Required)

First

Date of Signing(Required)

Day

Month

Year

Signature

If you are unable to use the signature box, leave it blank and we will help you at your first meeting.

How We Are Funded:

The West of England Combined Authority is working in partnership with WE Work for Everyone to deliver the Mayoral Priority Skills Fund. This fund provides flexible grants to meet current priority skills gaps in the region. This project is funded by the UK government through the UK Shared Prosperity Fund. WE Work for Everyone programme is delivered by Bristol City Council in partnership Bath and North East Somerset Council and South Gloucestershire Council.

Comments

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