Wigan ESOL referral form

This form should be used for referring your customer/ claimant to an ESOL assessment with Wigan ESOL Advice Service.  We will contact your client to arrange an ESOL assessment and discuss any suitable ESOL courses.

Only one referral form needs to be completed per customer/claimant.

 

1. Referral / claimant's full name and contact details:

Manchester ESOL logo *

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Any additional comments that may help with the assessment (there's no need to specify your client's 1st language):

 

2. Which organisation are you referring from?

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

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4. I confirm that the customer/ claimant 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 Wigan ESOL Advice Service to contact them.  *

 

Data protection statement:  The personal data you've provided will be kept securely by Wigan ESOL Advice Service in accordance with the relevant data protection legislation including the GDPR 2018. Our Privacy Notice which explains how we hold, use and protect your data can be found here:
ESOL Advice Service Privacy Notice