Mentoring Referral Form

Please see referral form for Mentoring Programmes below

Before submitting the Referral Form below, please remember to review the criteria thresholds and notices on the Mentoring Info Page.

  • YLF MENTORING REFERRAL FORM FOR PROFESSIONALS

    When submitting your referral, indicate the level of need and complete all sections below (for help, please refer to the notes/description in each section).
  • SECTION 1 - LEVELS OF NEED - Please Note

    YLF Mentoring Programmes uses Kent Support Levels Guidance as framework for assessment. Support is only offered to Level 2 (additional support) and Level 3 (intensive support). Please attend to the young person’s needs before referring. Indicate young persons level of need and check all needs that apply in the respective Level 2 and Level 3 sections:
  • SECTION 2 - REFERRAL DETAILS

    PLEASE COMPLETE ALL FIELDS IN DETAIL FOR REFERRAL TO BE CONSIDERED. ALL FIELDS ARE MANDATORY.
  • Young Person's Details

  • MM slash DD slash YYYY
  • If yes, how long for and reason why?
  • Referrer Details

  • Further Information

  • *Please note that this is just a suggestion. The final decision belongs to the Mentoring team, after assessment
  • *please include as much detail as possible. Not enough information will result in referral exclusion
  • *Please provide names and contact details if you have them – these include school counsellors or member of the school pastoral team, as well as any health and wellbeing programmes which the young person has undertaken
  • *Please list ALL details, i.e., specific learning difficulties/diagnosis’/medication and description of
  • *please include full details, e.g. history of DA, home dynamic, relationships etc.
  • *please include details of successful strategies when working with the young person
  • Outcome 1Outcome 2Outcome 3Outcome 4 
  • SECTION 3 - SIGNED CONSENT

    By completing the fields below you are consenting to the processing, sharing and storage of personal information as set out in the Privacy Notice for YLF Mentoring (this Notice can be found on the Mentoring Referral webpage of the YLF website)
  • *Please type your name as signed consent
  • MM slash DD slash YYYY
  • SECTION 4 - To be completed by the Mentoring Team