Make a referral | Share Community

If you have a disability and you're interested in coming to Share, please complete the form below.

If you are a social care professional, or a parent or carer, completing this form on behalf of someone else, please click the 'refer someone else' button above.

For further information or help filling out this form please email wellbeing@sharecommunity.org.uk or telephone 020 7924 2949.

Your personal details

First Name

Last Name

Which most accurately describes you?

Date of Birth

Street Address

Street Address Line 2

Borough

Town/City

Postcode

Country

Phone Number

Mobile Number

Do you have a disability?

Yes

If you have a disability, please tick all that apply

ADHD

Autism

Learning disability/difficulty

Mental health needs

Physical disability

Sensory impairment

Down's Syndrome

Other

There is a cost to attend Share, depending on the number of days attended, do you know how your place will be funded?

Yes

Application Details

Have you studied at Share before?

Yes

Do you have a social worker?

Yes

Share operates across four sites, which site(s) are you interested in attending?

Brixton

Clapham Junction

Tooting

Vauxhall

Please add any more information if you'd like to here

Complete this form if you're an adult social care professional or a parent or carer looking to refer someone to Share.

Details of our full referral process including timelines are available here.

For more information, or help filling out this form, please email wellbeing@sharecommunity.org.uk or telephone 020 7924 2949.

The Referrer's details

Referrer's First Name

Referrer's Last Name

Street Address

Street Address Line 2

Town/City

Postcode

Country

Referrer's Phone Number

Referrer's Mobile

Referrer's Email

Relationship to the applicant

Job Title

Your Organisation (if applicable)

The Applicant's Details

First Name

Last Name

Which most accurately describes them?

Date of Birth

Street Address

Street Address Line 2

Borough

Town/City

Postcode

Country

Phone Number

Mobile

Have they studied at Share before?

Yes

Do they have a disability?

Yes

If they have a disability, please tick all that apply

ADHD

Autism

Learning disability/difficulty

Mental health needs

Physical disability

Sensory impairment

Down's Syndrome

Other

There is a cost to attend Share, depending on the number of days attended, do you know how their place will be funded?

Yes

Do they currently have a social worker?

Yes

Share operates across four sites, which site(s) are they interested in attending?

Brixton

Clapham Junction

Tooting

Vauxhall