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Referral Information:

Embrace Education is a not-for-profit organisation that provides free tutoring and other services to disadvantaged students in Melbourne, Victoria. The vast majority of our tutors are Uni students. We are able to help students with most high-school subjects including ESL (English as a Second Language). Individual tutoring takes place at a local public library during the library's opening hours, or after-class at the student's school where an arrangement has been made with the school. All tutors are required to pass an interview and both a Working With Children and Police check, before being matched for individual tutoring.

To refer a student to Embrace for individual tutoring, please complete the below referral form. Preference is shown towards students who...

Are from a refugee, Indigenous or recent-migrant background
Are studying Yr 9, 10, 11 or 12 with a preference shown towards VCE students
Are studying at a relatively poorly performing, or under-privileged school
Are having difficulty completing their studies, and/or are under-achieving. i.e. we are not focussed towards providing A+ students with further assistance
Would be unable to pay for tutoring should we not be there to provide it freely

PRIVACY OF THIS INFORMATION

The information contained in this form is collected by Embrace Education Australia to enable us to match the referred student for tutoring with a suitable volunteer. This information will not be disclosed to any person, agency or organisation outside of Embrace Education without consent, unless we are legally obligated to do so. You may request access to the information we collect by contacting us at our email address. If you do not provide us with the information requested, Embrace Education will not be able to provide appropriate services to the referred student.

A Word Document Version of our Referral Form is available here. However to reduce our administrative burden and to increase the speed of your application, it is preferable to use the below online form.

Student Referral Form

Student Eligibility

Eligibility: *

	Yes	No
Is the student from a refugee background?
Is the student from Indigenous Australian descent?
Did the student arrive into Australia within the last 5 years?
Is the student in financial difficulty or other difficult circumstances?
Is there a history of disrupted schooling, or history of difficult circumstances which may create blocks to their learning?
Is the student studying at a relatively poorly performing school and/or is living in an area of socio-economic disadvantage?

This section is a quick screen to see if the student you are referring is eligible for our assistance. If you are able to answer yes to 2 or more of the above questions then the chances are the student is eligible. See the top of this page for additional criteria for which we give preference.

Student Details

First Name: *

Last Name: *

Gender: *

Date of Birth: *

Country of Origin: *

Year of Arrival into Australia: *

Student Contact Details

Address: *

Suburb: *

Home Phone Number:

Mobile Phone Number:

Email:

Emergency Contact

Full Name: *

Relationship to Student: *

Contact Phone Number 1: *

Contact Phone Number 2:

Further Details

School: *

Year Level: *

Subjects Studying: *

Areas in which student requires assistance: *

Medical conditions and allergies:

Please include a list of any relevant medical conditions, allergies or medications that may relate to this student.

Has the student ever shown dangerous personality traits or violence in the past?: *

Yes

No

Will the student be able to commit to turning up to tutoring sessions on time and with the right equipment?: *

Yes

No

Maybe

Further comments about the student including anything else you think we should know: *

Please include as much information as you can, as this will assist us greatly in matching the student to an appropriate tutor.

Referrer

Full Name: *

Organisation or relationship to student: *

Phone: *

Email: *

Have you obtained the student's verbal consent to being referred to Embrace Education?: *

Would you like to be kept up to date with the student's progress?:

Yes

No

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Primary links

Student Referral Form