Indian (39) White and Black African (36) Pakistani (40) White and Black Caribbean (35) Other Asian background (43) Mixed - any other ethnic background (38) African (44) White (31) English/Welsh/Scottish/Northern Irish/ British – Caribbean (16) White - Irish (32) Other Black/African/Caribbean Gypsy or Irish Traveller (33) background (17) White - any other (34) Chinese (42) Any ethnic group (98) Arab (47) Not provided (99) Male Female Disclosure of criminal convictions (to be completed by all applicants) Have you ever been convicted by the courts, cautioned, reprimanded or given a final warning by the police? No Yes If YES, please give details (If you wish you may give details in confidence to the college’s Safeguarding Manager) Section Two: Other People You Work With Has a community care assessment, common Yes No Don’t know assessment framework or improving choice for living and work assessment been carried out? If yes, please attach a copy. Name of Careers Address Telephone How often do adviser you see them? E mail Name of contact at Name of school/organisation Telephone How many current school/college Address days a week do you attend? E mail Name of current social Address Telephone How often do worker you see them? E mail Date last seen Name of previous Address Telephone Date last seen social worker E mail Name of current GP Address Telephone E mail Name of CAMHS Address Telephone How often do worker/psychologist/ you see them? other mental health worker Date last seen E mail
Indian (39) Pakistani (40) Other Asian background (43) African (44) Caribbean (16) Other Black/African/Caribbean background (17) Chinese (42) Arab (47) White and Black African (36) White and Black Caribbean (35) Mixed - any other ethnic background (38) White – English/Welsh/Scottish/Northern Irish/ British (31) White - Irish (32) Gypsy or Irish Traveller (33) White - any other (34) Any ethnic group (98) Not provided (99) Male Female Disclosure of criminal convictions (to be completed by all applicants) Have you ever been convicted by the courts, cautioned, reprimanded or given a final warning by the police? No Yes If YES, please give details (If you wish you may give details in confidence to the college’s Safeguarding Manager) Section Two: Other People You Work With Has a community care assessment, common assessment framework or improving choice for living and work assessment been carried out? If yes, please attach a copy. Yes No Don’t know Name of Careers adviser Address Telephone E mail How often do you see them? Name of contact at current school/college Name of school/organisation Address Telephone E mail How many days a week do you attend? Name of current social worker Address Telephone E mail How often do you see them? Date last seen Name of previous social worker Address Telephone E mail Date last seen Name of current GP Address Telephone E mail Name of CAMHS worker/psychologist/ other mental health worker Address Telephone E mail How often do you see them? Date last seen
Application-form-Hereward-amended-Sept-2018.docx