Contact Details and Referral Form

Email: elevate@bracknell-forest.gov.uk 

Phone: 01344 352777

Address: Elevate Bracknell Forest, Breakthrough Supported Employment, 9 Rectory Row, Rectory Lane, Easthampstead, Bracknell, Berkshire, RG12 7BN.

For careers guidance and support with post-16 transition into education, employment and training, please complete the referral form below. New referrals are reviewed weekly and allocated to a personal adviser who will contact you within seven days.

Consent

The council is obliged to collect and handle information about individuals in accordance with the Data Protection Act 2018 and the General Data Protection Regulation (GDPR). The Act also provides individuals with the right to request copies of their personal information. To find out more about Bracknell Forest GDPR and data collection, click here (link opens in new window).

The young person named in the form below consents to the use and processing of their information under UK GDPR law and the young person is aware that this referral form is being sent.

Young Person's Details

Full Name

Date of Birth (DD/MM/YYYY)

Email

Telephone

Gender Please select... Female Male Transgender Prefers not to say

Ethnicity Please select... White British White Irish Gypsy/Roma/Irish Traveller Any other White background White and Black Caribbean White and Black African White and Asian Any other mixed or multiple ethnic background Bangladeshi Indian Pakistani Any other Asian background Black African Black Caribbean Any other Black background Arab Chinese Any other ethnic group Prefers not to say

Street

Town

County

Postcode

Current or previous school Please select... College Hall Easthampstead Park Community School Edgbarrow School Garth Hill College Kennel Lane School Ranelagh School Sandhurst School The Brakenhale School Other - Please give details

School, if Other

Further Information

Tell us about your situation and how this could lead you to becoming NEET (Not in Education, Employment or Training)

Tell us about your future goals and how we could help you to achieve them

Please provide full details of any other supporting agency

Referrer's Details (if not the young person)

Name

Organisation

Email

Telephone

User Check

Enter characters above