Referral forms for School Partner use


This page if for the use of partner schools only. If you would like to discuss partnership, please contact Elle.


1:1 Mentoring

Mentoring Referral Form

Please complete this form for each student.

By default, each mentoring relationship is for one term as a minimum. Therefore, we will typically allocate new referrals to a youth worker at the beginning of each academic term.

Available for all year groups.

If you are unsure of how many students your school can refer each term, please email Michelle.

Referrals should be completed by the end of the preceding term.


Kintsugi Wellbeing Groups

Kintsugi Referral Form

Please complete this form for each student.

Each course consists of 10 sessions, therefore each course starts at the beginning of the school term. Each course can cater for 6 to 10 students of a similar maturity level.

Available for all year groups. It is designed for students with low level mental health concerns and is not a suitable alternative to counselling or professional mental health services. If you are unsure on suitability, please discuss the student with Michelle before making the referral.

Referrals should be completed by the end of the preceding term.



Contact details:

Elle Knight, The 180 Project Manager

Elle.knight@mycommunitychurch.org.uk
01374 484101
Tuesdays, Wednesdays & Fridays