Addiction, Recovery & Outdoor Education Referral Form 2020
Email *
Referral Criteria
In order to be given a place on the course students must fulfil the following criteria
Be over 18 years old at time of starting
Be stable in their recovery (on 50ml and under and not using substances beyond those prescribed)
No educational requirements however prospective students must be keen to learn
Have a letter from their doctor saying they are capable of taking part fully in the course
Be in receipt of a dept of social protection payment or be on CE or TUS scheme
Name *
Phone number *
Address *
E mail address *
Referring service *
Key worker / contact person *
key worker / contact persons e mail address *
Key worker / contact person's phone number *
Why do you want to do this course *
Have you done any other courses relating to addiction, community development, psychology etc *
What experience do you have of sports, adventure sports or outdoor activities *
Do you have any experience leading others, coaching sports, mentoring or being in positions of responsibility *
How would you describe your literacy level *
Have you anything else that you think that we should know about you.
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