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Initial Engagement
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The information gathered on this form, is so we can ensure we are getting to know you, your circumstances and can offer you the best support and advice possible. It is stored securely on our system. This information must be completed before any activities are undertaken as part of the project. These details will be stored securely and retained at least until the end of December 2033, in compliance with the Data Protection Act 2018. This information will be used to evaluate this project and to report to the European Social Fund for monitoring purposes. You may be contacted to discuss your involvement in the project. For the purposes of the Data Protection Act 2018, the Department for Work and Pensions is the data controller in respect of information processed which relates to your participation in the project funded by the European Social Fund.
Mentor
-- No Selection --
Events - Employment & Skills Calderdale
Events - Lead Accountable Body Team
Venue*
-- No Selection --
Bull Green House
Calderdale Adult Learning
Facetime
Manor Heath Park
MS Teams
Northern College
Shibden park
Telephone Call no video
The Hub Pellon
The Space
Whats App
Zoom
Date
Date Registered is invalid, use the following format dd-mmm-yyyy
Unique Participant ID No.
0
Contact Info
Title*
Mr
Miss
Mrs
Ms
Dr
Other
First Name*
Forename is required
Middle Name
Text 3 is required
Surname (s)*
Surname is required
Like to be known as
Greeting is required
I identify my gender as*
Male
Female
Transgender
Other
Non-Binary
Date of Birth*
Date Of Birth is invalid, use the following format dd-mmm-yyyy
Participant Address*
Postcode:
Building Name:
Secondary Name:
Street:
District:
Town:
County:
Household Status*
Owns with either a mortgage, loan or shared ownership
Private rent tenant
Hostel/ Temp Acc.
No Fixed Abode
Social Housing
Owned outright (no mortgage)
Not Known
Do you have an email address
Yes
No
Email Address*
Email is required
Mobile Phone*
Mobile is required
Mobile Phone must be 11 digits
Home Telephone
Telephone is required
Home Telephone must be 11 digits
NI Number*
National Insurance is required
Equality & Diversity Information
Do you describe yourself as having a Disability? *
-- No Selection --
Yes
No
Which Ethnicity do you describe yourself as?*
asian/asian british - bangladeshi
asian/asian british - chinese
asian/asian british - indian
asian/asian british - pakistani
Asian, Asian British or Asian Welsh
asian/asian british - other
black/african/caribbean/black british - african
black/african/caribbean/black british - caribbean
black/african/caribbean/black british - other
Black, Black British, Black Welsh, Caribbean or African
mixed/multiple - white and asian
mixed/multiple - white and black african
mixed/multiple - white and black caribbean
mixed/multiple - other
Mixed or Multiple ethnic groups
white - english/welsh/scottish/northern irish/british
white - irish
white - roma, gypsy or irish traveller
Gypsy, Irish Traveller or Roma
white - other
other ethnic group - arab
White
other ethnic group - other
Other ethnic group