Referring for Support at The ClementJames Centre

This is a referral form for organisations to use to refer clients for support at The ClementJames Centre.

If you would like to get support for yourself, please click here.

If you would like to refer a young person for Literacy & Numeracy Catch-up Support at the Centre, please click here to be taken to our Literacy & Numeracy referral form.

Unfortunately, due to high demand and reduced capacity as a result of staff illness, we have had to temporarily pause our Information, Advice & Guidance service. While this situation is temporary, we are currently unable to give a date as to when our service will be available again.

If a client is currently working with an adviser for a particular advice issue, we will continue working with them until this issue is resolved
If a client is already booked in for an advice appointment we will still be able to provide this support
If a client has not used our advice service before, does not currently have a booking for an appointment or has a new issue which they need support with for which they are not currently working with an adviser, we advise that they contact one of the organisations listed here, who may be able to provide support

Unfortunately this also means that we now have a six-week wait for our Employment Skills Programme. If you refer for support, please be aware that we will contact your client in the New Year when our Employment Skills Programme starts taking appointments again.

We apologise for any inconvenience caused. If you would like to speak to a member of staff about these changes, please call the centre on 020 7221 8810.

Thank you for taking the time to fill out this referral form. If you need support filling out this form, please contact reception@clementjames.org or give us a call on 020 7221 8810.

Privacy Notice

At The ClementJames Centre, we're committed to protecting and respecting your privacy.

Please see our privacy notice attached here, and tick here when both you and your client have read and agree to the terms laid out in it.

Who We Can Support

Please be aware that we can only support residents who live in or who are housed in either Kensington & Chelsea, Hammersmith & Fulham or Westminster.

Please select the borough the client is a resident of or housed in:

We also have criteria that clients need to meet to access support. At least one of the following means that they are able to access support at the Centre.

Please select any of the following that apply to the client:

Receiving benefits

Have a household income of less than £25,000

Living in social housing (this includes council, temporary accommodation and housing associations)

Have a child/ward receiving free school meals

Your Details

It is helpful for us to have your details, should we need to contact you about this referral.

Full Name

Organisation

Other:

Role

Contact Number

How will you still be working with the client being referred to us going forward?

Can we contact you about this referral? We will only do so to discuss details relating to the referral, when such details are needed in order to best support the client.

Please tick here if you would like to be subscribed to our mailing list to hear about upcoming workshops, programmes, events and opportunities at The ClementJames Centre.

Support Referral

What is the main type of support that you are enquiring about for the client?

Which of the following programmes do you perceive to be best suited to the circumstances of the client?

Booster Programme: Short-term unemployed (3-6 months)Refresh Programme: Medium term unemployed (6-12 months)Spark Programme: Long-term unemployed (12 + months)

Enhance Programme: Employed, but financially unstable & in receipt of means-tested benefits

Please tell us, in as much detail as possible, what the client would like support with:

Please select the other types of support that the client is interested in receiving at ClementJames:

Employment Skills Programme - We equip people with the skills to feel more job ready and to achieve their employment goals

Please select the other types of support that the client is interested in receiving at ClementJames:

Wellbeing Support - We support people to people to increase their confidence, resilience and support networks, and that of their family and friends

Client's Details

Please only give us your client's contact details with their explicit consent and after they have read and agreed to our privacy notice.

First Name

Last Name

Date of Birth (dd/mm/yyyy)

Gender

Client's self-described gender, if known:

Ethnicity

Other or client's self-described ethnicity, if know:

Contact Number

House Number & Street Name

Post Code

Client's Language and Communication Needs

We ask the following questions in order to provide the best support for the client throughout their time at The ClementJames Centre. Please provide as much information as you can.

Does the client have any learning or physical accessibility needs that we should know about?

Please provide us with more details:

Does the client have any communication or language needs that we should know about?

Please provide us with more details:

We offer English classes for adults. Would the client like to find out more about how we can support them with this?

Please tick here if the client needs assistance to exit the building in the event of an emergency evacuation. Staff will prepare a Personal Emergency Evacuation Plan (PEEP) for them.

Submit Your Form

Please submit the form below.

Contact Information