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Mentoring Referral Form

By completing this form, you confirm that you have received authority from the person you are referring to. You understand that Arise Mentoring will record and store personal information about you and the young person so they can make a judgment as to the level of support required and can provide appropriate advice and support. The young person and you both understand that we have the right to access, change, restrict and erase the information on this form if we choose. Arise Mentoring will not share this information with anyone without seeking our permission.