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

Risk of NEET Indicators

It is important that you complete this section and select as many Risk of NEET Indicators as are applicable.

Please select and add indicators to the 'Selected Indicators' list on the left from the 'Available Indicators' list on the right, by using the Add and Remove buttons. Hold down control when clicking to select multiple items.

Selected Indicators

Add Remove

Available Indicators

Alternative Provision or Pupil Referral Unit Asylum Seeker / Refugee Autism Care Leaver Child & Adolescent Mental Health Service Child in Need Children from Armed Forces Families Children Looked After Children Missing Education Common Assessment Framework Does not have a Post-16 Offer Elective Home Education English as an Additional Language Fixed Term Exclusions Free School Meals Gypsy, Roma & Traveller Homelessness Insufficient Suitable Local Provision Low Attainment Low Attendance Medical and Physical Health Condition Multi-Agency Safeguarding Hub (MASH) referral Poor Transport Links Postcode Deprivation Private Fostering Arrangement Pupil Premium Rural Area Social, Emotional and Mental Health Special Educational Needs Special Educational Needs and Disabilities - EHCP Substance Misuse Teenage Parent Teenage Pregnancy Troubled Families Programme Workless Household Young Carer Youth Offending Service

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