Making a referral is easy – download a pdf or Word version of the form via the buttons below, and email or post it back to:

Suite 16
West Lancashire Investment Centre
White Moss Business Park
Maple View
Lancashire WN8 9TG

T: 07852 416563

The referral will be assessed and a member of our team will get in touch with you with a decision.

If you have any questions, you can also call and speak to one of the team on 07852 416563

Please use this document to
PRINT and fill in using PEN
Click on READ ONLY once it has


Please use this document to
DOWNLOAD and TYPE in answers
TAB through the fields
Fill in the blanks


PLEASE NOTE these documents are often updated. Please save a link to this page and download the most current version when needed.