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Application / Referral Form

If you or a a girl or woman that you know would benefit from our support, please fill in this form.

Academies - Application Form

This form helps us learn more about you so that we can support you in the best way possible. All information is held confidentially by the Inspiring Leadership Foundation and only shared with individuals who are directly responsible for your development. To ask any questions, please contact us at [email protected].

Please note that all questions with an asterix (*) must be completed.

1. Are you completing this form for yourself or on behalf of someone else? *

To be completed by the applicant:

7a. Gender *

Education and Employment

8. Highest Level of Education *
9. Current Occupational Status *
10. Tick the box below that best describes your income status *

Support Needs

11a. Which of these do you feel like you lack? *
11b. Why do you need support? (Please check all that apply) *
12. Which of our programmes, services and resources are you interested in *
14. What technology do you have access to? *
Select as many as suitable of:
15. Have you got access to internet and/or mobile data? *

Additional Information

16. Are you a single parent? *
17. Are you a refugee or asylum seeker? *
19. Have you received support from the Inspiring Leadership Foundation before? *

Declaration

I declare that the information provided in this form is true and complete to the best of my knowledge.

Yes, I authorise the Inspiring Leadership Foundation to communicate directly.

To be completed by referring partner/ by someone on behalf of the beneficiary:

Your relationship to the beneficiary/ the person you are completing this form on behalf of:
what are they studying? What are their future education plans?
What qualifications has the beneficiary earned?
What work experience does the beneficiary have?*
What are the candidate’s strengths and their interests and hobbies?
What are the areas the beneficiary like to develop and learn about?
What type of work experience placements would the beneficiary like us to find for them?
37. Do they need to attend with a parent / carer? *
38. What technology do they have access to? *
Select as many as suitable of:
39. What computer skills do they have? *
Select as many as suitable of:
What type of work experience placements would the beneficiary like us to find for them?
41. Do they need to attend with a parent / carer? *
Can you tell us more about the candidate’s personality and social skills?
Can you provide some background information to help us fully understand the candidate's needs (family situation, current living arrangements, difficulties, etc.)
What else should the team be aware of?

IMPORTANT COMMUNICATION AUTHORISATION

To ensure that we follow the right protocols, please confirm if the Inspiring Leadership Trust (ILT) can communicate with the applicant directly regarding their programme.

Authorisation *

To be completed by referring partner/ by someone on behalf of the beneficiaries:

Your relationship to the beneficiary/ the person you are completing this form on behalf of:

IMPORTANT COMMUNICATION AUTHORISATION

To ensure that we follow the right protocols, please confirm if the Inspiring Leadership Trust (ILT) can communicate with the applicants directly regarding their programme.

Authorisation *

Candidate names and details

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