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Referral Form.

We're delighted to be accepting referrals for our Marmalade Companions 2023 project. Please note we are now closed to new referrals for Christmas and hope to reopen later in the year.

Our projects:



Please check you meet the eligibility criteria for the service before completing the form. We ask that you complete as much information as possible. If you have any difficulty completing this form, please call 07566 244788 or email


If you have taken part in a Marmalade Trust service previously, you do not need to complete this form. Please contact Marmalade Trust. ​

Important information for referrers



Referring others

If you are referring on behalf of an individual, please ensure you have the person’s explicit consent to complete this form. Please ensure they understand how Marmalade Trust will store and use their data before submitting.

If you are a referrer, you must include your name, phone number, the organisation you work for and your role (if applicable) in the referrers detail box at the end of the form. Unfortunately, we are unable to accept referrals without this information.


If you are self-referring, please include N/A in the referrer details box.

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