Referral Form

For support and to make a referral to Inside Connections please fill out the form below

Who Can Refer Me?

Contact Details

Your location

Are you currently unemployed?
Are you currently in training or education?
Are you currently claiming Universal Credit?
Have you ever been convicted of a criminal offence?
This will not be used against you, it is for our records only
Do you hold a full UK driving license?

Check the boxes that best describe your status

Services we can offer

Your situation*

If you should choose to provide us with personal information - by filling out this form and submitting it to us through the app - we will use that information to respond to your message and to help us get the support you have requested. Inside Connections does not collect personal information for commercial marketing or distribution to any private organizations


0800 689 1676

We are open
Monday to Friday (9am - 5pm)

If you wish to make a referral please use our online referral form, you can refer yourself or via a professional in agreement with you.



Inside Connections Support CIC
Kirkdale Community Centre
238A Stanley Road
L5 7QP



We endeavour to answer all email enquiries within 1 business day although this may not be possible during busy periods

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