If you prefer to submit a paper referral, click here to download and print one.
Fax to 250 352 3750

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Program Referral Form

Referrals will be responded to within 5 business days. Note that some programs may have a wait list.

Program Referral Form

Client / Parent Name:

Child / Youth Name (if applicable):

Contact Information

Guardian Name (if applicable):

Referring Worker’s Name:

Section Field

To which NCS program(s) are you making a referral?
Groups:

Note: All referrals will be responded to within 3 business days. Please note that some programs will have waiting lists.

If you prefer to submit a paper referral, click here to download and print one.