Salford ESOL referral form 2024-25

This form should be used for referring your customer/ claimant to us so that we can contact them to arrange an ESOL assessment and discuss any suitable ESOL courses.

1. Referral / claimant's full name and contact details. LEARNER MUST BE A SALFORD RESIDENT:
(Required information)
*

First name	*
Surname	*
Postcode (must be a Salford resident)	*
Phone number	*
Email address (if known)

3. Your contact details (please note we need these details to keep a clear record of who has made a referral and also if we need to contact you):
(required information) *

Name:	*
Email:	*
Relationship to the learner e.g. work coach, support worker etc	*

Additional relevant comments, information or need which can help with the assessment:

4. I confirm that the customer/ claimant is from SALFORD and has indicated their interest in applying for an ESOL course and has asked to be contacted about it. Please note, we will not be able to progress this referral without the customer's/claimant's agreement for Salford ESOL Advice Service to contact them. Please do not continue with this form without discussing this first with your customer/claimant, and that the customer/claimant is aware you may ask for an update from us about this referral.

If your client is not from Salford, we will NOT contact them or you to notify any further. Please on refer clients to the ESOL hub in the area in which they live. Please do not make more than one referral. We will send a text/email with the link for learners to apply online. Please ensure your client's the or mobile number is correct. *

Yes
No

Data protection statement: The personal data you've provided will be kept securely by Salford ESOL Advice Service in accordance with the relevant data protection legislation including the GDPR 2018. Our general Privacy Notice which explains how we hold, use and protect your data can be found here: https://www.salford.gov.uk/legal-notices/privacy-statement/

If you have any concerns about how your personal information is used, please contact us at infogovernance@salford.gov.uk

1. Referral / claimant's full name and contact details. LEARNER MUST BE A SALFORD RESIDENT: (Required information) *

2. Referral organisation's details: *

3. Your contact details (please note we need these details to keep a clear record of who has made a referral and also if we need to contact you): (required information) *

1. Referral / claimant's full name and contact details. LEARNER MUST BE A SALFORD RESIDENT:
(Required information)
*

3. Your contact details (please note we need these details to keep a clear record of who has made a referral and also if we need to contact you):
(required information) *