Please complete the following for monitoring purposes. The information provided on this form will be treated as strictly confidential: Are you? (you Unemployed In full time In part time employment may tick more employment than one box) In full time In part time Self employed education education If unemployed, Less than 6 6-11 months More than 12 months for how long? months What is the GCSE A Level NVQ (note level) Under- highest National Diploma graduate qualification Post Graduate No qualifications Other (please specify) you hold? Do you Yes (please No Prefer not to answer consider specify) yourself to have a disability? Which of the following groups White British White Irish White Other Mixed White and – – – do you belong Caribbean to? Put a tick in the relevant box. Mixed White Mixed Other Asian or Asian Asian or Asian – – and British Indian British Pakistani – – African Asian or Asian Asian or Asian Black or Black Black or Black British British other British British African – – – – Bangladeshi Caribbean Black or Black Chinese Other British - other Do any of the A young person that is A young person A young A young person following apply excluded or at risk of not in education, person who is a young to you? Put a exclusion from training or with parent? tick in the mainstream education? employment? mental relevant box. health issues? A young person who is A young person A young A young person a carer for a family who has been, person who lives in an member. or is, an asylum who has area described as seeker or been in economically refugee? care or is disadvantaged/or a looked has multiple after indices of person? deprivation Please select the option which best describes your sexuality Lesbian Heterosexual I do not wish to disclose this Gay Bisexual Thank you for completing
Please complete the following for monitoring purposes. The information provided on this form will be treated as strictly confidential: Are you? (you may tick more than one box) Unemployed In full time employment In part time employment In full time education In part time education Self employed If unemployed, for how long? Less than 6 months 6-11 months More than 12 months What is the highest qualification you hold? GCSE A Level NVQ (note level) National Diploma Under- graduate Post Graduate No qualifications Other (please specify) Do you consider yourself to have a disability? Yes (please specify) No Prefer not to answer Which of the following groups do you belong to? Put a tick in the relevant box. White – British White – Irish White – Other Mixed White and Caribbean Mixed – White and African Mixed – Other Asian or Asian British – Indian Asian or Asian British – Pakistani Asian or Asian British – Bangladeshi Asian or Asian British – other Black or Black British – Caribbean Black or Black British – African Black or Black British - other Chinese Other Do any of the following apply to you? Put a tick in the relevant box. A young person that is excluded or at risk of exclusion from mainstream education? A young person not in education, training or employment? A young person with mental health issues? A young person who is a young parent? A young person who is a carer for a family member. A young person who has been, or is, an asylum seeker or refugee? A young person who has been in care or is a looked after person? A young person who lives in an area described as economically disadvantaged/or has multiple indices of deprivation Please select the option which best describes your sexuality Lesbian Heterosexual I do not wish to disclose this Gay Bisexual Thank you for completing
2016%20DocLab%20application%20form.docx