Referral form for Employment and counselling services

This referral form only needs to be completed if you are referring a job seeker for our free services. For all others, please make an appointment with our administrator.

If you are a human and are seeing this field, please leave it blank.

Referral Form

Type of Service Requested *
Full employment Services
Work-related Anxiety Counselling Service
Anxiety Counselling followed by Employment Services
Transition from school to work

Person's Details

Name *

Date of Birth *

Address 1 *

Address 2

City

Post Code

Phone

If you only have a landline, please put the landline number in the mobile box below.

Mobile (Required) *

Email

Ethnicity *

Emergency Contact Details

Emergency Contact Name *

Relationship to Emergency Contact

Emergency Contact Phone Number *

Referrer Details

Referrer Name *

Referring Agency/Service *

Referrer Address *

Referrer Phone *

Referrer Email (A valid email address is required) *

General Practitioner (GP) or Health Specialist

GP Name *

GP Practice *

Phone Number of GP

Benefit Details

Benefit Type *
Supported Living
Job seeker deferred
None

Work and Income Number

Employment details (for employment services)

Does the person have a CV? If yes, please bring it to first appointment.

What sort of the job is the person looking for?

How many hours do they want to work?

Disability or Challenges to Employment *

Other Disability Agencies Involved

Please email any additional documents to admin@ces.org.nz.

Any other comments.

reCAPTCHA *

Latest client feedback

“Your services are excellent and I’m really grateful. One of the reasons I work hard is to honour the effort you put into supporting me in my career.” Carlton, September 2017

“I highly recommend anyone to come and see any of the consultants … they are welcoming and they are the people to talk to if you are looking for a job. Just come and talk to them.” Marsha, July 2017

“I found that the consultant immediately picked up on where I’d been and what I needed. He bought me back on track.” John, July 2017

“Thanks, you made me feel a whole lot better about myself; I wouldn’t have been able to do it without you, thanks again.” Nicky, June 2017

“I was provided with the service which I was expecting, and I was given other options specific to my needs. The Catapult website has elaborate information as to the services they provide.” Prashant, June, 2017

“I appreciated everything you guys did for me. You were easy to understand and everything you taught me came in useful.” Mark, May 2017

Shelley says it worked so well for her having both services in the same place, “rather than being sent here, there and everywhere to sort it all out, I could get it all here in the same bubble… it felt like a supportive bubble. Because it’s under one roof – you get to know the people around. It felt good coming into Catapult each time because I’d sort of got to recognise everyone working there even if it was just by seeing them around the place”. Shelley, September 2017

Inspiring and Supporting Cantabrians

Our story

Our services

Career and employment services

Work-Focussed Anxiety Management Counselling Service

Useful Information

Success Stories

Our people

Staff

Trust Board

Patron

For Employers

Services

What employers are saying about our service

Useful links

Videos

Shane has a dream IT job

Luke enjoys helping people find employment

Giovanna talks about her job at Bakels

Employer-win, employee-win recruitment

Tony has been at Canterbury Linen for 10 years

People Catapult has assisted into employment talk about their jobs

Employers talk about their experiences of recruiting staff through Catapult

Masha’s Feedback on Catapult

Contact

Referral form

Blog

Donate:

Carlton
“Your services are excellent and I’m really grateful. One of the reasons I work hard is to honour the effort you put into supporting me in my career." Carlton, September 2017 "I highly recommend anyone to come and see any of the consultants … they are welcoming and they are the people to talk to if you are looking for a job. Just come and talk to them.” Marsha, July 2017 "I found that the consultant immediately picked up on where I’d been and what I needed. He bought me back on track.” John, July 2017 "Thanks, you made me feel a whole lot better about myself; I wouldn’t have been able to do it without you, thanks again.” Nicky, June 2017 "I was provided with the service which I was expecting, and I was given other options specific to my needs. The Catapult website has elaborate information as to the services they provide." Prashant, June, 2017 "I appreciated everything you guys did for me. You were easy to understand and everything you taught me came in useful.” Mark, May 2017 Shelley says it worked so well for her having both services in the same place, “rather than being sent here, there and everywhere to sort it all out, I could get it all here in the same bubble… it felt like a supportive bubble. Because it’s under one roof – you get to know the people around. It felt good coming into Catapult each time because I’d sort of got to recognise everyone working there even if it was just by seeing them around the place”. Shelley, September 2017
Follow us on

Find us at: 478 Barrington Street PO Box 33368 Barrington Christchurch 8244 Phone: (03) 365 7005

Some of our partners:

Proudly powered by WordPress