Building Better Opportunities Stafford and South Staffordshire Referral Form
Please use this form to make referrals into the BBO programme. We aim to make initial contact with the participant to discuss the project within 2 working days. They will then be contacted by a BBO advocate to arrange a meeting within 5 working days.
Building Better Opportunities Stafford and South Staffordshire is a £2.3m programme, which is funded by the Big Lottery Fund and European Social Fund, and is managed by Business Enterprise Support and delivered by 16 partners across the south of the county.
Section 1: Participant's Information
Please complete the first section with the participant's information.
Name *
Your answer
Gender *
Age *
Telephone Number *
Your answer
Email Address
Your answer
Address (inc. Postcode) *
Your answer
Is support required with any of the following? Please tick all that are appropriate. *
Required
Section 2: Appointment Details
If a direct appointment has been made, please give the date.
MM
/
DD
/
YYYY
And time.
Time
:
And Venue
Your answer
Section 3: Referrer's Information
Please complete the second section with the referrer’s information if you are referring from a Building Better Opportunities partner or another organisation. If you are self-referring you can leave this section blank.
Name
Your answer
Organisation
Your answer
Email Address
Your answer
Telephone Number
Your answer
Disclaimer
If you are an organisation, referring on behalf of someone else. Please confirm that you have read the following statement to them and they are aware their information will be shared.
By submitting this form, you consent that information held within it may be shared with Building Better Opportunities partners or other organisations used by the Building Better Opportunities programme. *
Required
*
Required
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