REFERRAL FORM

Numeracy Referral
Is the participant over the age of 19 from January 1st 2024?
Does the participant currently reside in Pembrokeshire?
Has the participant obtained Level 2 / GSCE Maths A-C?
Name of Project Participant
Name of Project Participant
First
Last
Please indicate if you would require travel assistance to attend sessions
Are you a smoker?
Are you living with/recovering from any mental health issues?
Would you be interested in receiving free counselling & mental health support?

If you are referring on behalf of another person, please ensure that they have signed and agreed to the accuracy of the information in this form.

Privacy Notice:

The information collected through this Referral Form will be used solely for the purpose of ascertaining your suitability and requirements for the Numeracy Project. Your information will be treated with confidentiality and will not be shared with third parties.

Your rights

Under the Data Protection Act 2018, you have the right to find out what information the government and other organisations store about you.

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GOVERNMENT FUNDED

Our Numeracy Project has received £405,000 from the UK Government through the UK Shared Prosperity Fund (UKSPF).

The funding comes from the UK Government’s Multiply initiative, through Pembrokeshire County Council.

GOVERNMENT FUNDED

Our Numeracy Project has received £405,473 from the UK Government through the UK Shared Prosperity Fund (UKSPF).

The funding comes from the UK Government’s Multiply initiative, through Pembrokeshire County Council.

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