G.L.O.W Service: Self-referral form

If you’re aged 11–25 and live in Medway, Dartford, Gravesham, or Swanley, our GLOW programme can help you feel more confident, connected and ready for what’s next.

G.L.O.W Service: Referral Form

Young Person details


Unfortunately, you’re not eligible for the GLOW service as it’s specifically for young carers or young people receiving Early Help or social care support.

Please visit our Children and Young People’s Services pages to find other support options that may suit you.

 

Young Person contact details:


Parent/ Carer contact details (if below 16):


Referral Reason


If you are a professional completing this referral on behalf of a young person, please provide your contact information below.

Referrer Details