Mentoring Project Referral form
Please complete and submit this form together with your client/member/patient. You can alternatively send it by post to: Borderlands Mentoring Project, The Assisi Centre, Lawfords Gate, Bristol, BS5 0RE. If you have any queries about this form or the Mentoring project, please call the mentoring manager, Susanna on 07713 695 845. Please make sure you read the guide to referrers before submitting the referral.
Thank you and look forward to working with you.
First and last name
Borderlands Member number
Level of English
Date of arrival to Bristol and current address
Refused asylum seeker
If other, please specify
Prefer not to say
Purpose of mentoring. Please when completing this section make sure to think about practical goals (eg finding volunteering opportunities, get to know Bristol, improve English, access services or social activities, etc) as well as emotional goals (eg increase confidence)
Any additional information regarding language requirements or particular needs
Do you confirm that the client have sufficient English to engage in a mentoring scheme without interpreters
Do you confirm that the client understand that Susanna from Borderlands will contact them for further information
Name of organisation and of referrer, telephone and email
Send me a copy of my responses.
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