KRAN Learning for Life Referral Form

KRAN Learning for Life Referral Form

Please note: KRAN does not currently have spaces available. Referrals will be held on a waiting list.
Thank you for contacting KRAN and referring to us. We welcome referrals for Young People aged 16-19. Please ensure that this form is completed by a Social Worker / PA with permission from an Education Support Officer from a local authority that is working with the Young Person (The ESO authorise the funding of the placement) or a foster carer on behalf of the local council. For an 18+ young person, funding will need to be agreed on a case-by-case basis. For any other referral or enquiry please contact the office on 01227 634320. Once we have received the referral we will identify if it meets our funding criteria and we are able to meet their needs. We will then contact you to arrange a possible assessment / start date. The Young Person will remain on our waiting list until a suitable space is available.
Data Privacy Notice

KRAN stores the data in this referral in accordance with its Data Protection Policy (GDPR) including Data Retention Policy & our Privacy Notice. The referrer should explain to the young person that their details are being shared, why we need them and what their rights are.
Referrer Details
Who is completing this referral?*
What is your connection to the Young Person?
Referrer First Name*
Referrer Last Name*
Referrer Phone Number*
Please enter a valid phone number.
Referrer Email*
example@example.com
Young Person Details
Has the Young Person consented to this referral?*
Please give details for no consent given
Young Person's First Name*
Young Person's Last Name*
Date of Birth*

DayMonthYear
Date
Does the Young Person have their own phone?*
Mobile Phone Number
Contact Email
example@example.com
Gender Identity*
Religion*
Other Religion*
Accommodation Type*
Other Accommodation Type*
What is the Young Person's connection to Kent? *
Address (Street)*
Address (City)*
Address (County)*
Address (Postcode)*
Country of Birth*
Nationality*
Did the young person arrive to the UK alone?*
Date of Arrival to the UK (if exact date is unknown, please give an estimate)*

DayMonthYear
Age on Arrival to the UK*
Current Immigration Status*
Language Spoken*
Other Language Spoken *
Liberi Number*
Is the Young Person on the NTS? (We currently have no spaces for Young People moving on the NTS in Canterbury)*
Are there any Safeguarding Concerns? Please consider concerns related to the young person, as well as, the safety of other young people*
Safeguarding Concern Details - Please give as much details as possible regarding any concerns, and please include any details of historic or current violent behaviour. You will be contacted by the Early Intervention Case Worker. Following this referral, you MUST inform us of any changes to the safeguarding and wellbeing of the Young Person. *
Health or Medical Concerns (If 'Unknown' or 'None', please write this below)*
Is the young person allowed to travel alone? *
As part of the Young Person's education we will leave the hub buildings and go on trips in the local area for example parks, libraries, museums and churches. Do you give consent? (Any larger trips outside the local area will result in a separate consent form)*
Please give details about this Young Person's educational background and any known learning needs*
Please note: As part of the Young Person's curriculum entitlement, we will deliver Sexual Health and Relationship Education. If you would like to discuss this further please contact our Early Intervention Case Worker: sarah.hagues@kran.org.uk
Support Details
Does the Young Person have a Foster Carer?*
Foster Carer Name*
Foster Carer Phone Number*
Please enter a valid phone number.
Foster Carer Contact Email*
example@example.com
Does the Young Person have a Social Worker?*
Social Worker Name*
Social Worker Local Authority & Social Work Team
Social Worker Phone Number*
Please enter a valid phone number.
Social Worker Email*
example@example.com
Does the Young Person have a Social Worker Assistant?*
Social Worker Assistant Name*
Social Worker Assistant Organisation
Social Worker Assistant Email*
example@example.com
Social Worker Assistant Phone Number*
Please enter a valid phone number.
Does the Young Person have a Personal Advisor?*
Personal Advisor Name*
Personal Advisor Organisation
Personal Advisor Email*
example@example.com
Personal Advisor Phone Number*
Please enter a valid phone number.
Social Worker or Personal Advisor Manager Name
Social Worker or Personal Advisor Manager Number
Please enter a valid phone number.
Social Worker or Personal Advisor Manager Email
example@example.com
Does the Young Person have a Housing Support Worker?*
Housing Support Worker Name*
Housing Support Worker Organisation
Housing Support Worker Email*
example@example.com
Housing Support Worker Phone Number*
Please enter a valid phone number.
Does the Young Person have a Community Support Officer from a local council?*
Community Support Officer Name*
Community Support Officer Organisation
Community Support Officer Email*
example@example.com
Community Support Officer Phone Number*
Please enter a valid phone number.
What is the name of the Young Person's VSK Officer, if they have one?
Referral Reasons (Hide)
Should be Empty:

KRAN Learning for Life Referral Form

Data Privacy Notice

Referrer Details

Young Person Details

Support Details