Mentoring

The Tigers Trust can offer 1-1 support for young people aged 8-18, at an early intervention stage.

The aim is to help identify their needs promoting positive change to young people and their families. The programme will help support young people into positive activities in the community, as well as educate them on topics such as child criminal exploitation. The sessions will be tailored to meet the individual needs on of the young person with no fixed end date.

For any questions, please email [email protected] or [email protected].

Please complete the form below for the young person:

First Name:

Last Name:

Date of Birth:

Age:

Gender:

Ethnicity:

Address:

Contact details for the child/young person:

Parent/Guardian name and number:

Parent/Guardian relationship to child/young person:

School contact name and number:

Allocated Team/Social Worker with contact details:

Any other key agencies involved (i.e. School) with contact details:

Please note that any child under MAPPA who has committed sexual offences will not be accepted on the program as this is beyond our threshold. Is the child or young person involved with MAPPA of have they committed a sexual offence?

What is the reason for Referral?

What CCE/Exploitation concerns do you have?

What support has been provided to date and what has been the outcome/s if any?

What additional support is now required? (ie substance misuse, housing, mental health):

What is the reason for requesting this additional support?

Additional supporting information relating to interests and hobbies / relevant previous engagement etc.

Level of Vulnerability:

High

Medium

Low

Re-Offending Risk:

High

Medium

Low

Risk of Serious Harm:

High

Medium

Low

Is there:

Risk to yourself

Risk to staff

Risk to others

Please advise if there is any reason the child/YP should not be seen alone:

Please confirm is the child/YP is currently on any court order and the details of the order:

If other(s), please specify:

If known, please let us know any other factors which may affect how we support the Child/Young Person. Please include in this section details of any Mental Health or Disabilities:

Youth Voice: Have you Discussed the Referral with the Young Person. Please record the Young Persons Views. Including anything they would like to get out of the programme:

Diversity & Monitoring (Child /YP)

	Child/Young Person Details
Ethnicity	Ethnicity, Child/Young Person Details:
Physical Disability (If applicable)	Physical Disability (If applicable), Child/Young Person Details:
Medical Conditions (If known)	Medical Conditions (If known), Child/Young Person Details:
Religion	Religion, Child/Young Person Details:
Learning Difficulty/Disability	Learning Difficulty/Disability, Child/Young Person Details:
SEN (Please provide if applicable)	SEN (Please provide if applicable), Child/Young Person Details:

Referral Agency Information

	Child/Young Person Details
Referral Organisation:	Referral Organisation:, Child/Young Person Details:
Referring Staff Name and Role:	Referring Staff Name and Role:, Child/Young Person Details:
Email:	Email:, Child/Young Person Details:
Telephone Number:	Telephone Number:, Child/Young Person Details:
Organisation Address:	Organisation Address:, Child/Young Person Details:
Has consent been gained by parent/guardian (Y/N):	Has consent been gained by parent/guardian (Y/N):, Child/Young Person Details:

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