Creative Apprenticeships APPLICATION FORM Please complete all the questions fully. We will allocate interviews based on answers provided – continue on separate sheets if more space is needed. This programme is aimed at young people who have left school/college aged 16-18 or 19+
Return applications to: COLLAGE ARTS LEARNING TEAM Chocolate Factory 2 4 Coburg Road, Wood Green London N22 6UJ
All applications will be treated confidentially. We will contact you by phone or in writing to arrange a suitable interview date. Please make sure you fill in a contact telephone number, address and email. Title (Ms/Miss/Mrs/Mr)
tel: 020 8829 8900; fax: 020 8365 8686 web: www.collage-arts.org email: info@collage-arts.org
First Name
Date of Birth
Age
Surname/Family Name
National Insurance No
Permanent Home Address:
Postcode:
Borough:
Home Tel No:
E-mail address:
Mobile Tel No:
EMPLOYMENT STATUS Are you unemployed?
Yes
No
If YES how long?
Which benefits are you claiming? For how long?
Name of Adviser (JobCentre Plus or Support Agency): Name and Address of Local JobCentre Plus/ Support Agency and phone number: If NO, is your work Fulltime/ Part-time or Freelance?
How many hours per week?
Name of Employer/Company: Address of Employer/Company, phone number & email:
1.
Where did you hear about Collage Arts and this course?
Any Previous Applications
CURRENT AND PREVIOUS ACTIVITIES 2. Please provide details of past education or training qualifications gained in any field: Dates
3.
Duties/Activities
What do you hope to achieve by completing this programme? (tick as appropriate) Improvement in Creative Skills
Higher Courses, eg, University
Work Experience
Full or Part-time job
Networks/Contacts in the field
Self-employment (set up own business)
_____________________________________________________________
Do you have any learning difficulty and/or disability for which you require assistance for access, equipment or special help? Learning Difficulty, Disability or Health Condition
6.
Course Information
Company
Other (please specify) 5.
Qualification
Please provide employment details and include any voluntary work (dates, job title and main responsibilities), listing your most recent jobs first: Dates
4.
Establishment
Yes
No
Requirements (continue on a separate sheet if necessary)
This course operates in an environment which positively challenges racism, sexism, homophobia (ie, antigay/lesbian) and any other type of discrimination. How would you find working and studying in this environment?
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7.
What other interests/hobbies do you have?
I DECLARE THAT THE INFORMATION GIVEN ON THIS FORM IS TRUE AND ACCURATE.
Signature:
_________________________________
Name:
_________________________________
Date: _____________________
THANK YOU FOR COMPLETING THE APPLICATION FORM. COMPLETE THE EQUAL OPPORTUNITIES TRACKING FORM ON PAGE 4 AND RETURN BOTH FORMS TO: COLLAGE ARTS LEARNING TEAM Chocolate Factory 2 4 Coburg Road, Wood Green London N22 6UJ or email application to: nathan@collage-arts.org
EQUAL OPPORTUNITIES STATEMENT: Collage Arts is fully committed to eliminating all forms of discrimination, whether based on race, gender, sexuality, marital status, disabilities, age, religious belief, or status in organisation.
DATA PROTECTION STATEMENT: The information on this form will be stored in a computerised database. The information will be used for statistical purposes only, and personal data will not be revealed to any organisations other than those declared to the Data Protection Registrar. Collage Arts is committed to implementing and complying with the Data Protection Principles of good computer practice.
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CONFIDENTIAL
Equal Opportunities Tracking Form Please complete this form in order to allow us to monitor the effectiveness of our Equal Opportunities Policy. All the information given will be treated in the strictest confidence. Full Name:
Gender: Male Female
Date:
□ □
Age: <16 16-18 19-24 25-49 50+
Priority Groups: Registered disabled Health Issues/Learning disabilities/ other disabilities (not registered) Refugee / Asylum Seeker Unemployed Lone Parent Ex-offender Homeless Person
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Ethnic Origin: 1 – White – British/UK 2 – White – Irish 3 – White – Other (Specify) □ a – French b – Italian
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c – Spanish
□
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d - ________________________ 4 – Mixed – White and Black Caribbean 5 – Mixed – White and Black African 6 - Mixed – White and Asian
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7 – Mixed – Other ( Specify) e - ________________________ 8 – Asian or Asian British – Indian 9 – Asian or Asian British – Pakistani 10 – Asian or Asian British – Bangladeshi 11 – Asian or Asian British – Other (specify) □ a – Chinese b – Japanese
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c – Sri Lankan
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d – Vietnamese
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12 – Black or Black British – Caribbean 13 – Black or Black British – African 14 – Black or Black British – Other 15 – Other (Specify) □ aAfghani □ bBrazilian □ cChilean □ dColumbian □ eCroatian □ fCzech □ gGreek □ hGreek Cypriot □ iIranian □ jIraqi □ kKosovan □ lKurdish □ m - Mexican □ nPolish □ oRussian □ pSerbian □ qTurkish □ rTurkish Cypriot
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16 – Prefer not to say
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e - _________________________
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