Please complete our one page referral form found here: (Referral Form). If you are having issues downloading the file, you can email firstname.lastname@example.org to receive a copy. Alternatively, you can call the RJCK office at 519-380-0931 and have a referral form completed over the phone, with assistance from staff.
Once filled out, please send the completed referral form back to RJCK – fax it to 519-380-9146 or send by email to a staff team member directly, OR email@example.com.
Release of Information
In order for RJCK staff to ensure the programming process runs smoothly, we often require a ‘Release of Information’ to be signed by Parents/Guardians. This ensures that we can work cooperatively with local community partners, including the youth’s school. If you do not have a hard copy and require one to complete the referral process, you can find the Release of Information document here: (Release of Information Document). Alternatively, you can email a staff team member directly, or firstname.lastname@example.org to receive a copy.